Healthcare Provider Details

I. General information

NPI: 1083670376
Provider Name (Legal Business Name): ANN F MAHANEY-PRICE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ANN MAHANEY REILLY

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 LOOP RD TUSCALOOSA VA MEDICAL CENTER
TUSCALOOSA AL
35404-5015
US

IV. Provider business mailing address

3701 LOOP RD TUSCALOOSA VA MEDICAL CENTER
TUSCALOOSA AL
35404-5015
US

V. Phone/Fax

Practice location:
  • Phone: 205-554-2822
  • Fax:
Mailing address:
  • Phone: 205-554-2822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN117702
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: