Provider Demographics
NPI:1922211820
Name:MAHONE, CELIA JEANNE (LPN)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:JEANNE
Last Name:MAHONE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3378 WHITE BEECH LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-2540
Mailing Address - Country:US
Mailing Address - Phone:330-792-2762
Mailing Address - Fax:330-792-2762
Practice Address - Street 1:3378 WHITE BEECH LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-2540
Practice Address - Country:US
Practice Address - Phone:330-792-2762
Practice Address - Fax:330-792-2762
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH106765164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2329939Medicare ID - Type UnspecifiedINDEPENDENT PROVIDER