# MS. KATHLEEN ELLEN MAHAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1669474532
- **Gender:** F
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | ARNP1343402 | FL | Yes |
| 363LF0000X | Family Nurse Practitioner | ARNP 1343402 | FL | — |

## Other

- **Enumeration date:** 08/11/2005
- **Last updated:** 08/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 070980800 | — | FL |
| 05 | — | 303373200 | — | FL |