Provider Demographics
NPI:1154062123
Name:PAYNE, CHRISTINA BLACK
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:BLACK
Last Name:PAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5716 JOAN LN
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4721
Mailing Address - Country:US
Mailing Address - Phone:202-538-7190
Mailing Address - Fax:
Practice Address - Street 1:896 SOUTHERN AVE SE APT 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3451
Practice Address - Country:US
Practice Address - Phone:202-309-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant