Individual
KATHLEEN M MAHON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5731
(320) 240-2118
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5731
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R-121023-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0404811
MEDICA HEALTH PLANS
—
01
—
1018331
PREFERRED ONE
—
01
—
123119
U CARE
—
01
—
52Q63MA
BLUE CROSS BLUE SHIELD
—
01
—
HP26475
HEALTH PARTNERS
—
Enumeration date
08/11/2005
Last updated
07/08/2007
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