Individual
KIMBERLY FOX MAHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
550 HARRISON ST, SUITE 230, SYRACUSE, NY 13202-3096
(315) 472-4424
(315) 475-8056
Mailing address
416 CHURCHILL LN, FAYETTEVILLE, NY 13066-2543
(315) 682-4236
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
442937
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442937
LICENSE
NY
Enumeration date
03/08/2007
Last updated
07/08/2007
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