Provider Demographics
NPI:1760101307
Name:PAYNE-GREEN, ERINN
Entity Type:Individual
Prefix:
First Name:ERINN
Middle Name:
Last Name:PAYNE-GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERINN
Other - Middle Name:
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6135 BELDART ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-1211
Mailing Address - Country:US
Mailing Address - Phone:414-412-9285
Mailing Address - Fax:
Practice Address - Street 1:6135 BELDART ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-1211
Practice Address - Country:US
Practice Address - Phone:414-412-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program