Healthcare Provider Details

I. General information

NPI: 1821911058
Provider Name (Legal Business Name): CATHLEEN MORGAN MAHONEY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6774 BEXHILL DR
LIBERTY TOWNSHIP OH
45044-9627
US

IV. Provider business mailing address

6774 BEXHILL DR
LIBERTY TOWNSHIP OH
45044-9627
US

V. Phone/Fax

Practice location:
  • Phone: 915-226-9373
  • Fax:
Mailing address:
  • Phone: 915-226-9373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0040995
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: