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General NPI Number Information
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NPI Number | 1497582316
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Entity Type | Individual
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Provider Name | MARC DAVIS PAYE
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Gender | Male
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Dates
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Enumeration Date | 09/16/2024
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 113 BROADWAY AVE N
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City | ROCHESTER
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State | MN
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Zip | 55906-3720
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Country | US
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Telephone | 507-206-0840
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Fax | 507-206-0318
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Provider Business Mailing Address
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Address Line | 113 BROADWAY AVE N
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City | ROCHESTER
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State | MN
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Zip | 55906-3720
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Country | US
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Telephone | 507-206-0840
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Fax | 507-206-0318
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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 | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 10832685
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License Number State | MN
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