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NPI Code Detail

MEDICARE: NICOLE PAYNE

MEDICARE: NICOLE PAYNE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist29887NC

General Provider Information

NPI Number : 1154934966
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE PAYNE
Provider Business Mailing Address
First Line : 7960 MOUNTAIN FALLS CT APT 205
Second Line :
City : RALEIGH
State : NC
Zip : 27617-1885
Country : US
Telephone Number : 919-645-7574
Fax Number :
Provider Business Practice Location Address
First Line : 2411 LANDMARK DR
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6524
Country : US
Telephone Number : 919-788-4203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2020
Last Update Date : 08/31/2020

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Directions to “ NICOLE PAYNE ” Practice Location

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