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General NPI Number Information
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NPI Number | 1063709640
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Entity Type | Individual
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Provider Name | DEANNA MARCHELLE MAHONEY ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 712 1ST TER STE 218
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City | LANSING
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State | KS
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Zip | 66043-1715
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Country | US
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Telephone | 816-944-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 712 1ST TER STE 218
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City | LANSING
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State | KS
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Zip | 66043-1715
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Country | US
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Telephone | 816-944-6828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2011031858
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-75545-082
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License Number State | KS
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