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1962170852
MALLORY NICOLE PAYNE
GARLAND, TX
NPI
1962170852
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1048565)
Enumeration Date
2021-09-03
Last Update Date
2023-09-22
Business Address
MALLORY NICOLE PAYNE
675 TOWN SQUARE BLVD STE 200
GARLAND, TX 75040-2991
Phone number: 574-546-1900
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Mailing Address
MALLORY NICOLE PAYNE
PO BOX 11114
FORT WAYNE, IN 46855-1114
Phone number: 574-546-1900
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