Mahoney, Kathryn A

Mahoney, Kathryn A is an individual health care provider with primary practice located at 9555 76Th St # 1200 , Pleasant Prairie WI 53158-1984. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mahoney, Kathryn A can be contacted via phone (262) 671-7300.

Contact Information

Primary practice address
9555 76Th St # 1200 Pleasant Prairie WI 53158-1984
Phone: (262) 671-7300
Fax: (262) 671-7315
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4512-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085010142 Illinois

Profile Details

NPI number 1083195580
LBN Legal business name Mahoney, Kathryn A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2018
Last updated Apr 4th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083195580 NPPES
Wisconsin MEDICAID 1083195580
Wisconsin Other 4512-23

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