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General NPI Number Information
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NPI Number | 1700345923
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Entity Type | Individual
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Provider Name | ALISON MAHAN
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 6117 MONONA DR
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City | MONONA
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State | WI
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Zip | 53716-4303
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Country | US
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Telephone | 608-807-6577
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Fax |
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Provider Business Mailing Address
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Address Line | 2670 MCGAW RD
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City | FITCHBURG
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State | WI
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Zip | 53711-5537
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Country | US
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Telephone |
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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 | 16384-33
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License Number State | WI
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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 | 4437333748
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License Number State | WI
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