Provider Demographics
NPI:1124414461
Name:PAYNE, CRISTY RENE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CRISTY
Middle Name:RENE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6714
Mailing Address - Country:US
Mailing Address - Phone:513-363-3765
Mailing Address - Fax:
Practice Address - Street 1:5730 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6714
Practice Address - Country:US
Practice Address - Phone:513-363-3765
Practice Address - Fax:513-363-3741
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17014-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily