Provider Demographics
NPI:1801373915
Name:PAYE, SIMON (RN)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:PAYE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290187
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-6187
Mailing Address - Country:US
Mailing Address - Phone:507-304-2985
Mailing Address - Fax:612-677-3611
Practice Address - Street 1:14853 PERIDOT ST NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-4910
Practice Address - Country:US
Practice Address - Phone:612-423-8624
Practice Address - Fax:612-677-3611
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN2459821163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health