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Individual

MELISSA M MAHON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA/ARNP

Contact information

Practice address
105 E LOCUST ST, BLOOMFIELD, IA 52537-0054
(641) 664-3602
(641) 664-3765
Mailing address
PO BOX 54, BLOOMFIELD, IA 52537-0054
(641) 664-3602
(641) 664-3765

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ARNP9207011
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
D-129549
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
BCBS
FL
05
PENDING
FL
Enumeration date
07/28/2009
Last updated
02/09/2012
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