Basic Information
| Provider Information | |||||||||
| NPI: | 1649291766 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAYTON | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | MARGUERITE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 840 E MCKELLIPS RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852039645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808347546 | ||||||||
| FaxNumber: | 4808338313 | ||||||||
| Practice Location | |||||||||
| Address1: | 840 E MCKELLIPS RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852039645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808347546 | ||||||||
| FaxNumber: | 4808338313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 01/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN026496 | AZ | N | Nursing Service Providers | Registered Nurse | 363LF0000X | AP0464 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.