Provider Demographics
NPI:1568174787
Name:MCMAHON MILLER, MAUREEN FRANCES (FNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:FRANCES
Last Name:MCMAHON MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-1124
Mailing Address - Country:US
Mailing Address - Phone:914-456-7968
Mailing Address - Fax:
Practice Address - Street 1:62 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-1124
Practice Address - Country:US
Practice Address - Phone:914-456-7968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY492481-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily