Provider Demographics
NPI:1033483326
Name:PAYNE, CHRISTIE (RD, LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 BRECKINRIDGE BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4932
Mailing Address - Country:US
Mailing Address - Phone:623-293-8266
Mailing Address - Fax:
Practice Address - Street 1:3305 BRECKINRIDGE BLVD STE 116
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4932
Practice Address - Country:US
Practice Address - Phone:578-829-2573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-03
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA864804133V00000X
AZRD 864804133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered