Individual
MR. GERARD H MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-BC
Contact information
Practice address
450 S WILLARD ST, SUITE 115, COTTONWOOD, AZ 86326-6743
(928) 634-5551
(928) 634-5604
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2559
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP2009
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042005
—
AZ
Enumeration date
09/29/2006
Last updated
12/08/2015
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