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General NPI Number Information
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NPI Number | 1265806871
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Entity Type | Individual
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Provider Name | CAITLIN MARIE MAHON APRN, FNP-C, RD, LD
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Gender | Female
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 960 S 4TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-3252
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Country | US
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Telephone | 502-676-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 960 S 4TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-3252
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Country | US
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Telephone | 502-676-7550
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2590
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1172802
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4048050
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License Number State | KY
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