Provider Demographics
NPI:1518030998
Name:MALONEY, PAULA A (PNP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:MALONEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 482 BOX 2874
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362
Mailing Address - Country:JP
Mailing Address - Phone:098-890-0173
Mailing Address - Fax:
Practice Address - Street 1:18 MDG
Practice Address - Street 2:
Practice Address - City:KADENA AFB
Practice Address - State:OKINAWA
Practice Address - Zip Code:96362
Practice Address - Country:JP
Practice Address - Phone:643-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104896363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics