Healthcare Provider Details

I. General information

NPI: 1487224853
Provider Name (Legal Business Name): KATHERINE PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE PAYNE

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E EMORY RD
POWELL TN
37849-4015
US

IV. Provider business mailing address

234 E EMORY RD
POWELL TN
37849-4015
US

V. Phone/Fax

Practice location:
  • Phone: 865-761-7110
  • Fax:
Mailing address:
  • Phone: 865-761-7110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45362
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: