| NPI | 1558791350 |
|---|---|
| Former Name | AMANDA MARIE PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2013041626) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013041626) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2024-05-22 |