Individual ProviderJaylen PayneNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address525 Technology Park Ste 109, Lake Mary, FL 32746-7107(407) 647-2346(662) 304-6580PECOS EnrollmentBased on the most recent information from CMS, provider Jaylen Payne is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1154174118Provider TypeIndividualFull NamePayne, JaylenCredentialDNPGenderMaleSole ProprietorYesEnumeration Date4/9/2024Last Updated1/23/2026Contact InformationPractice LocationPractice Address525 Technology Park Ste 109, Lake Mary, FL 32746-7107Phone(407) 647-2346FaxUnlisted FaxMailing LocationMailing Address8801 Pathstone Blvd Apt 2403, Pensacola, FL 32526-4557Phone(662) 304-6580FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11043349FloridaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense913738Mississippi