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General NPI Number Information
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NPI Number | 1326914060
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Entity Type | Individual
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Provider Name | ELIZABETH A PAYNE
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Gender | Female
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 1551 SUGARLAND DR
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City | SHERIDAN
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State | WY
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Zip | 82801-5721
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Country | US
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Telephone | 307-674-5575
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Fax |
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Provider Business Mailing Address
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Address Line | 8804 SHADOWLAKE WAY
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City | SPRINGFIELD
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State | VA
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Zip | 22153-2100
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Country | US
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Telephone | 703-839-3492
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Fax | 703-839-3492
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-1519
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License Number State | WY
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