| NPI | 1750371316 |
|---|---|
| Former Name | SUSAN LEE PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 548208) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 548208) |
| 164W00000X Licensed Practical Nurse (Licence: TX 548208) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2016-05-11 |