Provider Demographics
NPI:1831252527
Name:MAHONEY, BARBARA ANN (FNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
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 1:700 24TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1716
Mailing Address - Country:US
Mailing Address - Phone:804-734-6093
Mailing Address - Fax:877-874-1008
Practice Address - Street 1:13707 RIVER WALK PL
Practice Address - Street 2:APT 202
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-6167
Practice Address - Country:US
Practice Address - Phone:504-919-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA445293331363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily