Provider Demographics
NPI:1952805095
Name:PAYTON, ARLYNNE ANN (LPN)
Entity Type:Individual
Prefix:
First Name:ARLYNNE
Middle Name:ANN
Last Name:PAYTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ARLYNNE
Other - Middle Name:ANN
Other - Last Name:DEVIRGILIIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1811 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1259
Mailing Address - Country:US
Mailing Address - Phone:702-257-9638
Mailing Address - Fax:702-974-1653
Practice Address - Street 1:1811 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1259
Practice Address - Country:US
Practice Address - Phone:702-257-9638
Practice Address - Fax:702-974-1653
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse