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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669474532 | NPPES |
| Florida | MEDICAID | 070980800 | |
| Florida | MEDICAID | 303373200 |
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