| NPI | 1770826208 |
|---|---|
| Former Name | ALISA JEANETTE PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 313870) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP06874400) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |