Basic Information
| Provider Information | |||||||||
| NPI: | 1780605477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAYNE | ||||||||
| FirstName: | LESLIE | ||||||||
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| Credential: | ACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 48 CHAMPIONS RUN | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782587702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104812617 | ||||||||
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| Practice Location | |||||||||
| Address1: | 333 N. SANTA ROSA ST | ||||||||
| Address2: | CHRISTUS SANTA ROSA HOSPITAL - CITY CENTRE | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107042011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 10/11/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 596313 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.