Individual
MS. KRISTINA JO MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 DUNAWAY LN, AZLE, TX 76020-3207
(817) 692-0714
Mailing address
509 DUNAWAY LN, AZLE, TX 76020-3207
(817) 692-0714
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
632565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150393004
—
TX
01
—
84498U
BCBS
TX
Enumeration date
08/18/2005
Last updated
10/28/2013
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