Individual
MS. PERI ANNE MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
535 NE 6TH AVE, ESTACADA, OR 97023-9312
(503) 630-8550
Mailing address
4360 HOLLY HILLS BLVD, SAINT LOUIS, MO 63116-2253
(314) 481-3660
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
133957
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202005499
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133957
MISSOURI STATE BOARD OF NURSING--REGISTERED NURSE #
MO
01
—
2018001235
AMERICAN NURSES CREDENTIALING CENTER--PMHNP CERTIFICATION
—
05
—
500780769
—
OR
Enumeration date
05/14/2018
Last updated
02/01/2023
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