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General NPI Number Information
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NPI Number | 1023848637
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Entity Type | Organization
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Legal Business Name | PAYNE FAMILY NURSING AND WELLNESS INC
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Dates
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Enumeration Date | 08/07/2024
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 351 CORPORATE TERRACE CIR
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City | CORONA
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State | CA
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Zip | 92879-6028
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Country | US
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Telephone | 951-543-7712
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Fax |
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Provider Business Mailing Address
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Address Line | 19069 VAN BUREN BLVD STE 114 PMB 491
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City | RIVERSIDE
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State | CA
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Zip | 92508-2548
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Country | US
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Telephone | 951-543-7712
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ADAM PAYNE
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Credential | NP
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Telephone | 951-543-7712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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