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:
Health care specialties
| Specialty | Code | License # | 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 7 months 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 | 1083195580 | NPPES |
| Wisconsin | MEDICAID | 1083195580 | |
| Wisconsin | Other | 4512-23 |
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