Individual
LISA MARIE MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-8500
(913) 588-5000
Mailing address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-8500
(913) 588-5000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
76711
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-105805-022
RN LICENSE
KS
01
—
76711
KS NP LICENSE
KS
Enumeration date
02/16/2015
Last updated
02/16/2015
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