Individual
MS. KATHLEEN ROWAN MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, MSN, PHD
Contact information
Practice address
1900 N 9TH ST, SUITE 104, PHILADELPHIA, PA 19122-2024
(215) 765-6690
(215) 765-6694
Mailing address
1500 MARKET ST, LM 500 WEST TOWER, PHILADELPHIA, PA 19102-2100
(215) 985-2595
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
UP001097C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016148450001
—
PA
01
—
1590259
BLUE CROSS
PA
01
—
16621
BRAVO
PA
01
—
2268269000
KEYSTONE HEALTH PLAN EAST
PA
01
—
30027025
KEYSTONE MERCY HEALTH PLAN
PA
01
—
7934856
AETNA
PA
Enumeration date
06/12/2006
Last updated
07/20/2016
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