Provider Demographics
NPI:1538826722
Name:PAYNE, ANRINA (FNP)
Entity type:Individual
Prefix:
First Name:ANRINA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 HAWES AVE APT 330
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-4679
Mailing Address - Country:US
Mailing Address - Phone:612-703-0251
Mailing Address - Fax:
Practice Address - Street 1:1210 N CARROLL AVE
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4512
Practice Address - Country:US
Practice Address - Phone:817-488-6205
Practice Address - Fax:817-488-6367
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1038825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty