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Individual

MS. KATHLEEN ANN MAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
56 STARBRUSH CIR, COVINGTON, LA 70433-7208
(985) 871-0095
(985) 871-0529
Mailing address
1375 CORPORATE SQUARE DR, SLIDELL, LA 70458-3147
(985) 726-2655
(985) 643-9808

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN076670 AP05454
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1348228
LA
Enumeration date
05/07/2008
Last updated
05/17/2010
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