Provider Demographics
NPI:1639298458
Name:PAYNE, MARGARET (RNCS, MN, PNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RNCS, MN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 GROVE ST N
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-3876
Mailing Address - Country:US
Mailing Address - Phone:706-864-6700
Mailing Address - Fax:706-864-2599
Practice Address - Street 1:1055 GROVE ST N
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-3876
Practice Address - Country:US
Practice Address - Phone:706-864-6700
Practice Address - Fax:706-864-2599
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN068135363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000548369CMedicaid