Provider Demographics
NPI:1841381159
Name:STATZ-PAYNTER, JAMIE LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:STATZ-PAYNTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W BELTLINE HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4226
Mailing Address - Country:US
Mailing Address - Phone:608-250-1415
Mailing Address - Fax:608-250-1463
Practice Address - Street 1:2901 W BELTLINE HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4226
Practice Address - Country:US
Practice Address - Phone:608-250-1415
Practice Address - Fax:608-250-1463
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist