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Individual

PENNY TALCOTT MAYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CDCES

Contact information

Practice address
1550 S PIONEER WAY, MOSES LAKE, WA 98837-4613
(509) 793-9780
(509) 764-3246
Mailing address
660 S COOLIDGE ST, MOSES LAKE, WA 98837-1872
(509) 793-9715
(509) 764-3244

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN00165575
WA
163WS0200X
School Registered Nurse
RN00165575
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2040700
WA
Enumeration date
12/07/2012
Last updated
04/28/2021
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