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NPI Code Detail

MEDICARE: KIMBERLY C. PAYNE

MEDICARE: KIMBERLY C. PAYNE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist8118TN

General Provider Information

NPI Number : 1184793911
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY C. PAYNE
Provider Business Mailing Address
First Line : 10321 CASTLEBRIDGE CT
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-7218
Country : US
Telephone Number : 865-777-0119
Fax Number :
Provider Business Practice Location Address
First Line : 501 ADESSA PKWY STE A150
Second Line :
City : LENOIR CITY
State : TN
Zip : 37771-6719
Country : US
Telephone Number : 865-986-4530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY C. PAYNE ” Practice Location

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