Provider Demographics
NPI:1093586430
Name:EVANS MAYO, URIKA D (AGACNP)
Entity Type:Individual
Prefix:
First Name:URIKA
Middle Name:D
Last Name:EVANS MAYO
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7255 MORRISON DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2453
Mailing Address - Country:US
Mailing Address - Phone:240-398-9802
Mailing Address - Fax:
Practice Address - Street 1:7255 MORRISON DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2453
Practice Address - Country:US
Practice Address - Phone:240-398-9802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR145620363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care