Kathleen Ellen Mahan, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP1343402 Issued in FL

Practice address

7381 College Pkwy
Suite 110
Fort Myers, FL 33907-5548

Phone

(239) 482-1010

Fax

(239) 481-1481

NPI assigned

Aug 11, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1669474532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13740 CYPRESS TERRACE CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078827",
            "telephone_number": "239-275-5522",
            "fax_number": "239-275-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7381 COLLEGE PKWY",
            "address_2": "SUITE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075548",
            "telephone_number": "239-482-1010",
            "fax_number": "239-481-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "KATHLEEN",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 1343402",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1343402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070980800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303373200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen L. Magruder, M.S.W.
• Kathleen Maguire
• Anand Raj Mahadevan, MD
• Kamal Mahajan
• Mamta Mahajan, P.T
• Paula B Mahan, P.A.
• Eugene D Mahaney, MD
• Michelle Mahaney, ARNP
• Timothy J. Mahaney, APRN
• Mekaael Mahmoud

• Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.