Provider Demographics
NPI:1194359042
Name:PAYNE, CATHRINE MARYFAYE
Entity Type:Individual
Prefix:
First Name:CATHRINE
Middle Name:MARYFAYE
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 1:637 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOGANSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30230-1036
Mailing Address - Country:US
Mailing Address - Phone:678-552-8126
Mailing Address - Fax:
Practice Address - Street 1:637 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOGANSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30230-1036
Practice Address - Country:US
Practice Address - Phone:678-552-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-01
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer