Healthcare Provider Details

I. General information

NPI: 1669636668
Provider Name (Legal Business Name): BARBARA ANN MAHONEY RNCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA ANN SEXTON RN

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 N WAHSATCH AVE
COLORADO SPRINGS CO
80903-3102
US

IV. Provider business mailing address

419 N WAHSATCH AVE
COLORADO SPRINGS CO
80903-3102
US

V. Phone/Fax

Practice location:
  • Phone: 719-633-8182
  • Fax: 719-634-4167
Mailing address:
  • Phone: 719-633-8182
  • Fax: 719-634-4167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number45492
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: