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Individual

CYNTHIA MARIE MAHONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
181 NW BUNNELL AVE, GRANTS PASS, OR 97526-6012
(541) 474-9400
(541) 474-2232
Mailing address
PO BOX 2552, GRANTS PASS, OR 97528-0213
(541) 244-1261
(541) 787-8130

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
200250078NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100252
OR
01
200250078NP
STATE LICENSE#
OR
Enumeration date
05/04/2006
Last updated
10/05/2015
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