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General NPI Number Information
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NPI Number | 1760989073
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Entity Type | Individual
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Provider Name | WILLIAM JASON PAYNE APRN
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Gender | Male
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 05/14/2022
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Provider Practice Location Address
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Address Line | 1060 BROADWAY #3032
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City | ALBANY
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State | NY
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Zip | 12204
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Country | US
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Telephone | 518-400-2715
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Fax | 518-519-3331
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Provider Business Mailing Address
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Address Line | 1060 BROADWAY #3032
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City | ALBANY
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State | NY
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Zip | 12204
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Country | US
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Telephone | 518-400-2715
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Fax | 518-519-3331
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 24256
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License Number State | TN
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