Provider Demographics
NPI:1144521758
Name:MAYO, KAREN SHIELDS (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SHIELDS
Last Name:MAYO
Suffix:
Gender:F
Credentials:FNP-BC
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Mailing Address - Street 1:10535 HOSPITAL WAY
Mailing Address - Street 2:VA MEDICAL CENTER - HEMATOLOGY/ONCOLOGY
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655
Mailing Address - Country:US
Mailing Address - Phone:916-843-7008
Mailing Address - Fax:916-843-7088
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:VA MEDICAL CENTER - HEMATOLOGY/ONCOLOGY
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655
Practice Address - Country:US
Practice Address - Phone:916-843-7008
Practice Address - Fax:916-843-7088
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
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Provider Licenses
StateLicense IDTaxonomies
CARN426218163WX0200X
CANP20347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology