Individual
NICOLE LYNN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
3451 GOODMAN RD E, SUITE 115, SOUTHAVEN, MS 38672-9303
(662) 890-5555
(662) 890-8899
Mailing address
4631 STONE PARK BLVD, OLIVE BRANCH, MS 38654-6983
(662) 873-3467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R870070
MS
Other
Enumeration date
12/23/2007
Last updated
08/29/2012
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