Healthcare Provider Details

I. General information

NPI: 1992123186
Provider Name (Legal Business Name): LINDSAY S PAYNE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT STREET MEMORIAL BUILDING, WEST, FLOOR 1
CONCORD NH
03301
US

IV. Provider business mailing address

246 PLEASANT STREET MEMORIAL BUILDING, WEST, FLOOR 1
CONCORD NH
03301
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-1111
  • Fax: 603-485-7718
Mailing address:
  • Phone: 603-228-1111
  • Fax: 603-485-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1018
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: