Provider Demographics
NPI:1942978192
Name:PAYNE, KAYCIE MICHELLE
Entity type:Individual
Prefix:MRS
First Name:KAYCIE
Middle Name:MICHELLE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3784 STATE HIGHWAY T
Mailing Address - Street 2:
Mailing Address - City:PUXICO
Mailing Address - State:MO
Mailing Address - Zip Code:63960-8222
Mailing Address - Country:US
Mailing Address - Phone:573-217-8616
Mailing Address - Fax:
Practice Address - Street 1:702 MO-34
Practice Address - Street 2:
Practice Address - City:MARBLE HILL
Practice Address - State:MO
Practice Address - Zip Code:63764
Practice Address - Country:US
Practice Address - Phone:573-238-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant