Suzanne Marie Mahoney
Individual provider Active NPI Licensed Practical Nurse · Cottrellville, MI
NPI 1780156646 · NPPES record last updated Dec 17, 2018
Key facts
- NPI
- 1780156646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 4703108942 (MI)
- Practice address
- 475 Little Ave
Cottrellville, MI 48039-2813 - Phone
- (313) 806-9880
- NPI assigned
- Dec 17, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703108942 | MI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703108942 | MI | Yes |
Addresses
Primary practice location
475 Little Ave
Cottrellville, MI 48039-2813
Mailing address
475 Little Ave
Cottrellville, MI 48039-2813
Phone (313) 806-9880
Other providers in Cottrellville, MI
- Eileen Bachler
- Ronald Delano Brown
- Kirk J Lee
- Elizabeth Merlo
- Ronald Newell
- Michelle Schneider
- Darian Lynn Stevens
- VG'S Pharmacy Inc
All providers in Cottrellville, MI · Licensed Practical Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.