Provider Demographics
NPI:1821841222
Name:PAYANO, KATHY (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:PAYANO
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 TEXAS DR APT 425B
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6736
Mailing Address - Country:US
Mailing Address - Phone:504-715-7827
Mailing Address - Fax:
Practice Address - Street 1:3601 TEXAS DR APT 425B
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6736
Practice Address - Country:US
Practice Address - Phone:504-715-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2674801131744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management