Basic Information
Provider Information
NPI: 1114485877
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SMITH
FirstName: TOYA
MiddleName: PAYNE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 CANAL ST
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701123018
CountryCode: US
TelephoneNumber: 5047023000
FaxNumber:  
Practice Location
Address1: 2000 CANAL ST
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701123018
CountryCode: US
TelephoneNumber: 5047023000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/12/2019
LastUpdateDate: 04/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X203877LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
1205LA MEDICAID


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