Provider Demographics
NPI:1063806933
Name:PAYNE, JAMES NATHAN (NP-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:NATHAN
Last Name:PAYNE
Suffix:
Gender:M
Credentials:NP-C
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Mailing Address - Street 1:1604 BEACH VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564
Mailing Address - Country:US
Mailing Address - Phone:228-219-6706
Mailing Address - Fax:228-522-3383
Practice Address - Street 1:5090 GAUTIER VANCLEAVE RD
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-4803
Practice Address - Country:US
Practice Address - Phone:228-522-6700
Practice Address - Fax:228-522-3383
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MSR865473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily