Individual
MRS. SUSAN MARIE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6140 E SCOTT PL, SIERRA VISTA, AZ 85635-9530
(520) 458-2131
(520) 459-2959
Mailing address
6140 E SCOTT PL, SIERRA VISTA, AZ 85635-9530
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
5414
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169347
AHCCCS
—
Enumeration date
02/05/2009
Last updated
02/05/2009
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