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General NPI Number Information
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NPI Number | 1205665577
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Entity Type | Organization
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Legal Business Name | PAYNE NURSING SERVICES, LLC
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 5999 W MEMORY LN STE 1
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City | GREENFIELD
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State | IN
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Zip | 46140-7294
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Country | US
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Telephone | 317-779-1204
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Fax | 317-940-5759
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Provider Business Mailing Address
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Address Line | 6572 W CHARLESTON WAY
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City | MCCORDSVILLE
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State | IN
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Zip | 46055-9677
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Country | US
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Telephone | 317-779-1204
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Fax | 317-940-5759
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CARLA PAYNE
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Credential | NP
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Telephone | 317-779-1204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 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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