Healthcare Provider Details

I. General information

NPI: 1467693770
Provider Name (Legal Business Name): CYNTHIA D MAYO CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6803 MAYFIELD RD
MAYFIELD HTS OH
44124-2271
US

IV. Provider business mailing address

6803 MAYFIELD RD
CLEVELAND OH
44124-2271
US

V. Phone/Fax

Practice location:
  • Phone: 216-310-2567
  • Fax:
Mailing address:
  • Phone: 216-310-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07220818
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 323576
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: