MEDICARE: MS. EVELYN PAYTON STNA

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	376K00000X	Nurse's Aide	379554250101	OH

General Provider Information

NPI Number	:	1790060010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EVELYN PAYTON STNA

Provider Business Mailing Address
First Line	:	6725 E NATIONAL RD
Second Line	:
City	:	S CHARLESTON
State	:	OH
Zip	:	45368-9722
Country	:	US
Telephone Number	:	937-561-4891
Fax Number	:

Provider Business Practice Location Address
First Line	:	6725 E NATIONAL RD
Second Line	:
City	:	S CHARLESTON
State	:	OH
Zip	:	45368-9722
Country	:	US
Telephone Number	:	937-561-4891
Fax Number	:

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

Provider Enumeration Date	:	10/18/2011
Last Update Date	:	10/18/2011

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