Provider Demographics
NPI:1437433489
Name:PAYNE, CAMILLE ALECIA (APRN, FNP , DNP)
Entity Type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:ALECIA
Last Name:PAYNE
Suffix:
Gender:F
Credentials:APRN, FNP , DNP
Other - Prefix:MS
Other - First Name:CAMILLE
Other - Middle Name:ALECIA
Other - Last Name:PAYNE JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, FNP, DNP
Mailing Address - Street 1:24 SACHEM CIR
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-7403
Mailing Address - Country:US
Mailing Address - Phone:203-715-1319
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2307768363LF0000X
CT079610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily