Individual
MRS. JENNIFER MAHONEY
Active
Individual
MRS. JENNIFER MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP07699
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
NP07699
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344039
ANTHEM BLUE CROSS/BLUE SH
OH
01
—
1001149
QUALCHOICE
OH
01
—
107132
KAISER
OH
05
—
2507684
—
OH
01
—
341487428
TAX ID
OH
01
—
7441606
AETNA
OH
01
—
A60194
SUMMACARE
OH
01
—
P00191907
RAILROAD MEDICARE
OH
Enumeration date
07/07/2006
Last updated
02/24/2011
Update your record
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