Provider Demographics
NPI:1306080908
Name:PAYMON, LATONDA E (CRNP)
Entity type:Individual
Prefix:
First Name:LATONDA
Middle Name:E
Last Name:PAYMON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 WOODLEY PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-3834
Mailing Address - Country:US
Mailing Address - Phone:334-288-0009
Mailing Address - Fax:334-281-7453
Practice Address - Street 1:2611 WOODLEY PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-3834
Practice Address - Country:US
Practice Address - Phone:334-288-0009
Practice Address - Fax:334-281-7453
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL01-067220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-067220OtherALABAMA BOARD OF NURSING