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General NPI Number Information
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NPI Number | 1013294495
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Entity Type | Individual
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Provider Name | BRENNA DAWN PAYNE WHNP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2011
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 7620 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79124-2154
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Country | US
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Telephone | 806-676-3579
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Fax |
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Provider Business Mailing Address
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Address Line | 7620 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79124-2154
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Country | US
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Telephone | 806-676-3579
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | PAY104366803
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License Number State | TX
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