Provider Demographics
NPI:1891714507
Name:PAYNE, SHERRI SUE (CRNP)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:SUE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5104
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-0104
Mailing Address - Country:US
Mailing Address - Phone:724-654-8117
Mailing Address - Fax:
Practice Address - Street 1:1607 3RD STREET
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2427
Practice Address - Country:US
Practice Address - Phone:724-857-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5509363LW0102X, 363LP2300X
PATP006519V363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA500020704OtherRAILROAD MEDICARE