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General NPI Number Information
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NPI Number | 1093524811
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Entity Type | Individual
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Provider Name | SOUZ PAYNE REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 4080 MCGINNIS FERRY RD STE 104
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City | ALPHARETTA
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State | GA
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Zip | 30005-3901
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Country | US
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Telephone | 470-800-4232
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Fax | 470-800-4232
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Provider Business Mailing Address
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Address Line | 4830 ORCHARD PARK LN
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City | CUMMING
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State | GA
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Zip | 30028-6980
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Country | US
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Telephone | 404-955-5220
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Fax | 470-222-4522
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | PHCP013416
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License Number State | GA
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