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NPI Code Detail

MEDICARE: MS. ELIS MABEL FERNANDEZ PAYNE WHNP-BC

MEDICARE: MS. ELIS MABEL FERNANDEZ PAYNE WHNP-BC
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
1163WW0101XAmbulatory Women's Health Care Registered Nurse0001129600VA

General Provider Information

NPI Number : 1720392459
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIS MABEL FERNANDEZ PAYNE WHNP-BC
Provider Business Mailing Address
First Line : 450 ALASKAN WAY S STE 200
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2785
Country : US
Telephone Number : 888-731-8994
Fax Number :
Provider Business Practice Location Address
First Line : 450 ALASKAN WAY S STE 200
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2785
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2010
Last Update Date : 02/07/2025

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