Provider Demographics
NPI:1669636668
Name:MAHONEY, BARBARA ANN (RNCS)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:RNCS
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:SEXTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:419 N WAHSATCH AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3102
Mailing Address - Country:US
Mailing Address - Phone:719-633-8182
Mailing Address - Fax:719-634-4167
Practice Address - Street 1:419 N WAHSATCH AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3102
Practice Address - Country:US
Practice Address - Phone:719-633-8182
Practice Address - Fax:719-634-4167
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45492163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult