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Individual

LEMLEM W PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
401 BICENTENNIAL WAY STE 250, SANTA ROSA, CA 95403-2149
(707) 393-5747
Mailing address
1828 AUSTIN WAY, SANTA ROSA, CA 95404-3608

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
767996
CA
363L00000X
Nurse Practitioner
Primary
95016614
CA

Other

Enumeration date
11/20/2012
Last updated
02/18/2021
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