Healthcare Provider Details

I. General information

NPI: 1891484911
Provider Name (Legal Business Name): SARAH MAHONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH YOHNKE

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 09/29/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SCOTT CIR
HONOLULU HI
96818
US

IV. Provider business mailing address

202 MERCURY ST
HONOLULU HI
96818-5960
US

V. Phone/Fax

Practice location:
  • Phone: 808-446-9167
  • Fax:
Mailing address:
  • Phone: 610-906-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11051133
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: