Healthcare Provider Details

I. General information

NPI: 1750294872
Provider Name (Legal Business Name): LACHAE PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 DECATUR BLVD
INDIANAPOLIS IN
46241-9561
US

IV. Provider business mailing address

8901 RIVER CROSSING BLVD APT 333
INDIANAPOLIS IN
46240-2688
US

V. Phone/Fax

Practice location:
  • Phone: 317-455-2366
  • Fax:
Mailing address:
  • Phone: 317-445-5131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28244419A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: