Healthcare Provider Details

I. General information

NPI: 1306646799
Provider Name (Legal Business Name): PAYTON ELIZABETH CLUM NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CRESTWOOD DR
LEWIS CENTER OH
43035-2202
US

IV. Provider business mailing address

329 CRESTWOOD DR
LEWIS CENTER OH
43035-2202
US

V. Phone/Fax

Practice location:
  • Phone: 614-327-2560
  • Fax:
Mailing address:
  • Phone: 614-327-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0039937
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: