Mahoney, Leah Victoria

Mahoney, Leah Victoria is an individual health care provider with primary practice located at 66 Bramhall St , Portland ME 04102-3344. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Mahoney, Leah Victoria can be contacted via phone (207) 662-3157.

Contact Information

Primary practice address
66 Bramhall St Portland ME 04102-3344
Phone: (207) 662-3157
Fax: (207) 662-4257
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X CNP81875 Maine

Profile Details

NPI number 1013950153
LBN Legal business name Mahoney, Leah Victoria
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jan 11th, 2013 - about 13 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 1013950153 NPPES
New Hampshire MEDICAID 30349017

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