Provider Demographics
NPI:1568508844
Name:MAYO, REBECCA LOU (CNP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LOU
Last Name:MAYO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10025 ERLITZ NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114
Mailing Address - Country:US
Mailing Address - Phone:505-897-9867
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CTR
Practice Address - Street 2:MSC10 5550
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4253
Practice Address - Fax:505-272-4356
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMR32581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily