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NPI Code Detail

MEDICARE: SHANNON MAYO RN

MEDICARE: SHANNON MAYO RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0400XCase Management Registered Nurse0178057CO

General Provider Information

NPI Number : 1285381962
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MAYO RN
Provider Business Mailing Address
First Line : 2 S CASCADE AVE STE 140
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80903-1604
Country : US
Telephone Number : 719-463-5520
Fax Number :
Provider Business Practice Location Address
First Line : 2 S CASCADE AVE STE 140
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80903-1604
Country : US
Telephone Number : 719-463-5520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2022
Last Update Date : 06/27/2023

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