Basic Information
Provider Information
NPI: 1841705944
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAYNE
FirstName: SLOAN
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2004 HAYES ST STE 800
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032659
CountryCode: US
TelephoneNumber: 6153290570
FaxNumber:  
Practice Location
Address1: 4588 CAROTHERS PKWY
Address2:  
City: FRANKLIN
State: TN
PostalCode: 37067
CountryCode: US
TelephoneNumber: 6157164747
FaxNumber: 6157164085
Other Information
ProviderEnumerationDate: 12/11/2017
LastUpdateDate: 01/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X23432TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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