Healthcare Provider Details

I. General information

NPI: 1851471221
Provider Name (Legal Business Name): MARGARET ROSE PAYNE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 N MERIDIAN ST 2ND FLOOR
INDIANAPOLIS IN
46204-1098
US

IV. Provider business mailing address

850 N MERIDIAN ST 2ND FLOOR
INDIANAPOLIS IN
46204-1098
US

V. Phone/Fax

Practice location:
  • Phone: 317-554-2716
  • Fax: 317-554-2721
Mailing address:
  • Phone: 317-554-2716
  • Fax: 317-554-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number70000121A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: