Most Relevant Information
Provider Data
NPI Number: | 1003532045 |
Provider Name: | KEVIN DANIEL MAHONEY APRN |
Entity Type: | Individual |
Taxonomy Code: | 363L00000X |
Specialty: | Nurse Practitioner |
License Number: | 1153911 |
Most Important Dates
Enumeration Date: | 10/12/2022 |
Last Updated: | 10/12/2022 |
Provider Practice Location
1 AUDUBON PLAZA DR
LOUISVILLE
KY
402171318
Practice Location Phone/Fax
Phone: | 5026346767 |
Fax: | 5026346775 |
Provider Mailing Location
PO BOX 36218
LOUISVILLE
KY
402336218
Provider Mailing Phone/Fax
Phone: | 5026346767 |
Fax: | 5026346775 |