Provider Demographics
NPI:1588444822
Name:PAYNE, GABRIELLE BRANDYLYNN (PA)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:BRANDYLYNN
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RHETT ST APT 206
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-5029
Mailing Address - Country:US
Mailing Address - Phone:239-287-1687
Mailing Address - Fax:
Practice Address - Street 1:317 W EL MONTE WAY
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-1557
Practice Address - Country:US
Practice Address - Phone:559-591-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant