Provider Demographics
NPI:1861732265
Name:PAYTON, BENDU JAYCEE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:BENDU
Middle Name:JAYCEE
Last Name:PAYTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 OLD ARCH LN
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4826
Mailing Address - Country:US
Mailing Address - Phone:770-362-6068
Mailing Address - Fax:
Practice Address - Street 1:6160 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE A100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4578
Practice Address - Country:US
Practice Address - Phone:404-236-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN175549363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health