| Doctor Name: | PENNY TALCOTT MAYO |
| NPI Number: | 1134464738 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN00165575 |
| Business Practice Address: | 1318 W Ivy Ave Moses Lake, WA - 988372065 |
| Business Phone Number: | 5097662670 |
| Business Fax Number: | 5097662689 |
| Mailing Address: | 920 W Ivy Ave, MOSES LAKE |
| State: | WA |
| Postal Code: | 988372047 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2012 |
| NPI Last Update Date: | 12/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | RN00165575 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |