Provider Demographics
NPI:1265632962
Name:MAHONEY, BARBRA J (FNP)
Entity type:Individual
Prefix:MS
First Name:BARBRA
Middle Name:J
Last Name:MAHONEY
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 1:7130 SARAJEVO PL
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20189-7130
Mailing Address - Country:US
Mailing Address - Phone:202-863-9450
Mailing Address - Fax:
Practice Address - Street 1:US DEPT OF STATE M/MED/QI
Practice Address - Street 2:2401 E. STREET NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0001
Practice Address - Country:US
Practice Address - Phone:202-863-9450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN60682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily