Healthcare Provider Details

I. General information

NPI: 1922438563
Provider Name (Legal Business Name): EILEEN FRANCES MAHLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2013
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 12TH PL STE 10
PRESCOTT AZ
86305-1433
US

IV. Provider business mailing address

919 12TH PL STE 10
PRESCOTT AZ
86305-1433
US

V. Phone/Fax

Practice location:
  • Phone: 520-954-8281
  • Fax:
Mailing address:
  • Phone: 520-954-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5307
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: