Healthcare Provider Details

I. General information

NPI: 1548106651
Provider Name (Legal Business Name): PATRICE ANN CORTES MAYO
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: PATRICE MAYO

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 LEES SUMMIT RD
KANSAS CITY MO
64139-1236
US

IV. Provider business mailing address

PO BOX 53122
OKLAHOMA CITY OK
73152-3122
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-6885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: