Provider Demographics
NPI:1437781283
Name:PAYNE, VENESSA EMMA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VENESSA
Middle Name:EMMA
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 NE 131ST CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8254
Mailing Address - Country:US
Mailing Address - Phone:909-353-9063
Mailing Address - Fax:
Practice Address - Street 1:510 E MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2229
Practice Address - Country:US
Practice Address - Phone:405-766-8206
Practice Address - Fax:405-390-7409
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013819363LF0000X
OK212930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily