Provider Demographics
NPI:1487108650
Name:PAYAN, SIMONE A (CNM)
Entity type:Individual
Prefix:MS
First Name:SIMONE
Middle Name:A
Last Name:PAYAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0746
Mailing Address - Country:US
Mailing Address - Phone:956-277-1541
Mailing Address - Fax:956-380-4433
Practice Address - Street 1:4302 S SUGAR RD STE 201
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-277-1541
Practice Address - Fax:956-380-4433
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131534367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife