Provider Demographics
NPI:1306365689
Name:PAYTON, WIERA MARIE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:WIERA
Middle Name:MARIE
Last Name:PAYTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 INDIAN WOOD CIR STE 202B
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-4039
Mailing Address - Country:US
Mailing Address - Phone:419-578-8594
Mailing Address - Fax:
Practice Address - Street 1:1900 INDIAN WOOD CIR STE 202B
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537
Practice Address - Country:US
Practice Address - Phone:419-578-8594
Practice Address - Fax:855-618-2622
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily