Individual
JENNIFER MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1330 OAK LN STE 101, LYNCHBURG, VA 24503-2513
(434) 847-6132
Mailing address
1330 OAK LN STE 101, LYNCHBURG, VA 24503-2513
(434) 847-6132
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA57243
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2018
Last updated
11/02/2021
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