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General NPI Number Information
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NPI Number | 1700518941
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Entity Type | Individual
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Provider Name | KERI L MAYO PA
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Gender | Female
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 123 MEDICAL CENTER DR
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City | BRUNSWICK
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State | ME
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Zip | 04011-2652
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Country | US
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Telephone | 207-373-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 14 TERRA WAY
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City | FALMOUTH
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State | ME
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Zip | 04105
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Country | US
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Telephone | 207-272-0086
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2376
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License Number State | ME
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