Basic Information
| Provider Information | |||||||||
| NPI: | 1851471221 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAYNE | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 N MERIDIAN ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462041098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175542716 | ||||||||
| FaxNumber: | 3175542721 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 N MERIDIAN ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462041098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175542716 | ||||||||
| FaxNumber: | 3175542721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 364S00000X | 70000121A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.