Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | ARNP1470572 | FL |
NPI | 1235284951 |
---|---|
Provider Name | Kelly Erin Mahany |
First Address | Tarpon Springs, FL 34689-7520 |
Second Address | New Port Richey, FL 34652-4316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |