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General NPI Number Information
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NPI Number | 1881429389
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Entity Type | Individual
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Provider Name | PAYDAN ANNE CLAYTON
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Gender | Female
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1665 GIBSON AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-1873
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Country | US
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Telephone | 417-257-5946
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Fax | 417-257-5918
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Provider Business Mailing Address
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Address Line | 1665 GIBSON AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-1873
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Country | US
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Telephone | 417-257-5946
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Fax | 417-257-5918
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2024037225
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 2016020008
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License Number State | MO
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