Individual
MRS. REBA JEAN MAHAFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN MS FNP
Contact information
Practice address
123 S MCKINLEY AVE, RENSSELAER, IN 47978-2949
(219) 866-7222
(219) 866-7001
Mailing address
123 S MCKINLEY AVE, RENSSELAER, IN 47978-2949
(219) 866-7222
(219) 866-7001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001207A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
473320
MEDICARE
IN
Enumeration date
02/21/2007
Last updated
12/11/2015
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