Provider Demographics
NPI:1083255145
Name:MAYO, LANA BRIONNE (RN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:BRIONNE
Last Name:MAYO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:BRIONNE
Other - Last Name:HAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2073 OLYMPIC ST (COMMUNITY HEALTH CENTERS OF LANE COUNT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-3413
Mailing Address - Country:US
Mailing Address - Phone:541-682-3550
Mailing Address - Fax:541-682-3551
Practice Address - Street 1:151 W 7TH AVE STE 310
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2676
Practice Address - Country:US
Practice Address - Phone:541-220-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201605834163WG0000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice