Provider Demographics
NPI:1972753358
Name:PAYNE, KAREN M (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:PAYNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:2727 HEARNE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3917
Mailing Address - Country:US
Mailing Address - Phone:318-631-6400
Mailing Address - Fax:318-631-0300
Practice Address - Street 1:1202 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3910
Practice Address - Country:US
Practice Address - Phone:318-212-4889
Practice Address - Fax:318-212-4153
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2017-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN076356 AP05578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily