MEDICARE: LATONDA E PAYMON CRNP

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
1	363LF0000X	Family Nurse Practitioner	01-067220	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-067220	OTHER	AL	ALABAMA BOARD OF NURSING

General Provider Information

NPI Number	:	1306080908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONDA E PAYMON CRNP

Provider Business Mailing Address
First Line	:	2611 WOODLEY PARK DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-3834
Country	:	US
Telephone Number	:	334-288-0009
Fax Number	:	334-281-7453

Provider Business Practice Location Address
First Line	:	2611 WOODLEY PARK DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-3834
Country	:	US
Telephone Number	:	334-288-0009
Fax Number	:	334-281-7453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	10/21/2010

Similar Medicare Providers

1295779502 — HENRY G. JOHNSON, M.D., P.C.
Practice Location Address:

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36116-3834

Practice Phone: 334-288-3400
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1063511582 — ADOLESCENT & PEDIATRIC ASSOCIATES
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1831298355 — ALBERT Z HOLLOWAY MD
Practice Location Address:

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1457683831 — JOAN ELIZABETH FORD CPNP-PC
Practice Location Address:

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1073854105 — JULIAN E MCINTYRE PC
Practice Location Address:

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1831763499 — LISA KAY DANLEY
Practice Location Address:

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