Provider Demographics
NPI:1366914541
Name:PAYNE, CHRISTIE (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 SWALLOW DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4321
Mailing Address - Country:US
Mailing Address - Phone:214-924-5229
Mailing Address - Fax:
Practice Address - Street 1:3617 SWALLOW DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-4321
Practice Address - Country:US
Practice Address - Phone:214-924-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily