Provider Demographics
NPI:1881096501
Name:PAYNE, ANN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1071 OAK HILL CIR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-2948
Mailing Address - Country:US
Mailing Address - Phone:419-281-0163
Mailing Address - Fax:
Practice Address - Street 1:417 N KIBLER ST
Practice Address - Street 2:
Practice Address - City:NEW WASHINGTON
Practice Address - State:OH
Practice Address - Zip Code:44854-9426
Practice Address - Country:US
Practice Address - Phone:419-492-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0119469Medicaid
OHH238710Medicare PIN