Mahan, Kathleen Ellen

Mahan, Kathleen Ellen is an individual health care provider with primary practice located at 7381 College Pkwy Suite 110, Fort Myers FL 33907-5548. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Mahan, Kathleen Ellen can be contacted via phone (239) 482-1010.

Contact Information

Primary practice address
7381 College Pkwy Suite 110 Fort Myers FL 33907-5548
Phone: (239) 482-1010
Fax: (239) 481-1481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP 1343402 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1343402 Florida

Profile Details

NPI number 1669474532
LBN Legal business name Mahan, Kathleen Ellen
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Aug 4th, 2014 - about 10 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 1669474532 NPPES
Florida MEDICAID 070980800
Florida MEDICAID 303373200

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