Provider Demographics
NPI:1851986079
Name:PAYTON, AMANDA BETHANY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BETHANY
Last Name:PAYTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 PERRYVILLE ST
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-2012
Mailing Address - Country:US
Mailing Address - Phone:859-733-7000
Mailing Address - Fax:859-733-7044
Practice Address - Street 1:530 PERRYVILLE ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-2012
Practice Address - Country:US
Practice Address - Phone:859-733-7000
Practice Address - Fax:859-733-7044
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015489363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner