Individual
SAMANTHA GRACE MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3271
(508) 856-5911
Mailing address
5 2ND RD, HOPKINTON, MA 01748-2731
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
068205-21
NH
163WC0200X
Critical Care Medicine Registered Nurse
RN2298184
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2298184
MA
Other
Enumeration date
06/11/2019
Last updated
08/27/2021
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