| NPI | 1699070433 |
|---|---|
| Former Name | TERESA K MAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9208090) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9208090) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: FL ARNP9208090) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2020-10-22 |