Healthcare Provider Details

I. General information

NPI: 1184206708
Provider Name (Legal Business Name): HANNAH GREEN MAYO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK RD STE 205
AVON CO
81620-5428
US

IV. Provider business mailing address

PO BOX 5260
AVON CO
81620-5260
US

V. Phone/Fax

Practice location:
  • Phone: 970-331-2714
  • Fax:
Mailing address:
  • Phone: 888-453-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD.0000946
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: