Provider Demographics
NPI:1831338821
Name:PAYNE, KIMBERLY DAWN
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DAWN
Last Name:PAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 2ND ST E
Mailing Address - Street 2:
Mailing Address - City:FRUITHURST
Mailing Address - State:AL
Mailing Address - Zip Code:36262-3799
Mailing Address - Country:US
Mailing Address - Phone:256-201-1022
Mailing Address - Fax:
Practice Address - Street 1:1010 CHRISTINE AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5782
Practice Address - Country:US
Practice Address - Phone:256-235-3050
Practice Address - Fax:256-238-9875
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003450231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist