Individual
EMILY ANNE MAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5908 S 142ND ST, OMAHA, NE 68137-2800
(402) 354-1001
(402) 354-1910
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2160
NE
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026480100
—
NE
05
—
1871919555
—
IA
05
—
47068731734
—
NE
05
—
47068731741
—
NE
05
—
47068731749
—
NE
Enumeration date
03/05/2014
Last updated
07/29/2019
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