Provider Demographics
NPI:1144356031
Name:PAYSON, KATHRYN E (ARPNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:PAYSON
Suffix:
Gender:F
Credentials:ARPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JUPITER LAKES BLVD
Mailing Address - Street 2:BLDG 3000 SUITE 103
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7191
Mailing Address - Country:US
Mailing Address - Phone:561-748-1811
Mailing Address - Fax:561-748-1806
Practice Address - Street 1:210 JUPITER LAKES BLVD
Practice Address - Street 2:BLDG 3000 SUITE 103
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7191
Practice Address - Country:US
Practice Address - Phone:561-748-1811
Practice Address - Fax:561-748-1806
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1117712363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1117712OtherFL LICENSE