Provider Demographics
NPI:1417503624
Name:PAYNE, KAMILAH JEWEL (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KAMILAH
Middle Name:JEWEL
Last Name:PAYNE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:KAMILAH
Other - Middle Name:JEWEL
Other - Last Name:LYON/ BROWN /GILLIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:15318 ABOYNE LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4611
Mailing Address - Country:US
Mailing Address - Phone:346-442-6856
Mailing Address - Fax:
Practice Address - Street 1:525 N SAM HOUSTON PKWY E STE 245
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4016
Practice Address - Country:US
Practice Address - Phone:832-616-0698
Practice Address - Fax:713-513-5737
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142464363LF0000X, 163WW0000X, 364SF0001X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health