Provider Demographics
NPI:1265273890
Name:PAYTON, SHAWNTEL ELONN (DOULA)
Entity type:Individual
Prefix:
First Name:SHAWNTEL
Middle Name:ELONN
Last Name:PAYTON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 EXTERIOR ST APT 11K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2077
Mailing Address - Country:US
Mailing Address - Phone:917-755-8173
Mailing Address - Fax:
Practice Address - Street 1:530 EXTERIOR ST APT 11K
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2077
Practice Address - Country:US
Practice Address - Phone:917-755-8173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty