Healthcare Provider Details

I. General information

NPI: 1265312367
Provider Name (Legal Business Name): PAYTON BRIDGES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 GREENWAY CT
SANFORD NC
27330-6954
US

IV. Provider business mailing address

524 BOULDERBROOK PKWY
SANFORD NC
27330-7324
US

V. Phone/Fax

Practice location:
  • Phone: 919-708-1528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number354217
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024475
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: