Healthcare Provider Details

I. General information

NPI: 1770083875
Provider Name (Legal Business Name): DEBRA JO PAYNTER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N EWING ST
LANCASTER OH
43130-3372
US

IV. Provider business mailing address

2425 TOWNSHIP ROAD 138 NW
SOMERSET OH
43783-9523
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-8000
  • Fax:
Mailing address:
  • Phone: 740-605-4048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF02180230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: