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Individual
LAUREN MAHONEY
Active
Individual
LAUREN MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
99076677A
IN
363A00000X
Physician Assistant
Primary
PA2154
KY
363A00000X
Physician Assistant
TC520
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100417770
—
KY
Enumeration date
06/17/2016
Last updated
02/16/2023
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