Provider Demographics
NPI:1407516941
Name:PAYNE, COURTNEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1892 FINSBURY LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5017
Mailing Address - Country:US
Mailing Address - Phone:757-285-2739
Mailing Address - Fax:
Practice Address - Street 1:201 HANBURY RD E
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-6613
Practice Address - Country:US
Practice Address - Phone:757-482-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-24
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7572852739OtherPHONE NUMBER