Provider Demographics
NPI:1073624003
Name:PAYNE, KENNA D'ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENNA
Middle Name:D'ANN
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1300 S COULTER ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1712
Mailing Address - Country:US
Mailing Address - Phone:806-356-4000
Mailing Address - Fax:806-356-4018
Practice Address - Street 1:1300 S COULTER ST
Practice Address - Street 2:SUITE 206
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1712
Practice Address - Country:US
Practice Address - Phone:806-356-4000
Practice Address - Fax:806-356-4018
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist