Healthcare Provider Details

I. General information

NPI: 1255275061
Provider Name (Legal Business Name): CD PAYNE-HAYES ENTERPRISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 UNION ST S
CONCORD NC
28025-5264
US

IV. Provider business mailing address

57 UNION ST S
CONCORD NC
28025-5264
US

V. Phone/Fax

Practice location:
  • Phone: 704-956-9584
  • Fax:
Mailing address:
  • Phone: 704-956-9584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA HAYES
Title or Position: FOUNDER/CEO
Credential: HAYES
Phone: 704-956-9584