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General NPI Number Information
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NPI Number | 1942790035
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Entity Type | Individual
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Provider Name | PERI ANNE MAYES PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 535 NE 6TH AVE
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City | ESTACADA
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State | OR
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Zip | 97023-9312
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Country | US
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Telephone | 503-630-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 4360 HOLLY HILLS BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63116-2253
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Country | US
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Telephone | 314-481-3660
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 133957
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202005499
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License Number State | OR
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