Provider Demographics
NPI:1659544567
Name:MAHONEY, JENNIFER LEAH (RN, MSN, FNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LEAH
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:RN, MSN, FNP
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Mailing Address - Street 1:PO BOX 986
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-0986
Mailing Address - Country:US
Mailing Address - Phone:919-690-3487
Mailing Address - Fax:919-690-3246
Practice Address - Street 1:1614 NC HIGHWAY 56
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-8297
Practice Address - Country:US
Practice Address - Phone:919-575-6103
Practice Address - Fax:919-575-6817
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC163683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily