Provider Demographics
NPI:1932426392
Name:PAYNTER, SHARON LYNN (LPN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:PAYNTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LEIPSIC
Mailing Address - State:OH
Mailing Address - Zip Code:45856-9217
Mailing Address - Country:US
Mailing Address - Phone:419-577-6897
Mailing Address - Fax:
Practice Address - Street 1:625 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LEIPSIC
Practice Address - State:OH
Practice Address - Zip Code:45856-9217
Practice Address - Country:US
Practice Address - Phone:419-577-6897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125214164W00000X
KY2040203164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse