Most Relevant Information
Provider Data
| NPI Number: | 1003586157 |
| Provider Name: | GLENANNETTA MAYES LPC-C, BSN, RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0400X |
| Specialty: | Registered Nurse |
| License Number: | 0089870 |
Most Important Dates
| Enumeration Date: | 09/19/2021 |
| Last Updated: | 04/19/2024 |
Provider Practice Location
1402 MAXEY DR
MUSKOGEE
OK
744031101
Practice Location Phone/Fax
| Phone: | 9186166968 |
| Fax: |
Provider Mailing Location
1402 MAXEY DR
MUSKOGEE
OK
744031101
Provider Mailing Phone/Fax
| Phone: | 9186166968 |
| Fax: |