Healthcare Provider Details

I. General information

NPI: 1992395016
Provider Name (Legal Business Name): THOMAS J MCMAHON APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S MARTIN LUTHER KING JR BLVD
HAMILTON OH
45011-3216
US

IV. Provider business mailing address

820 S MARTIN LUTHER KING JR BLVD
HAMILTON OH
45011-3216
US

V. Phone/Fax

Practice location:
  • Phone: 513-887-8500
  • Fax: 513-737-8196
Mailing address:
  • Phone: 513-887-8500
  • Fax: 513-737-8196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0028257
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: