Healthcare Provider Details

I. General information

NPI: 1043139181
Provider Name (Legal Business Name): JILL PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 N 18TH ST
UNIONVILLE MO
63565-1601
US

IV. Provider business mailing address

103 N 18TH ST
UNIONVILLE MO
63565-1601
US

V. Phone/Fax

Practice location:
  • Phone: 660-947-2429
  • Fax: 660-947-3870
Mailing address:
  • Phone: 660-947-2429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: