MEDICARE: CINDY B MCMAHON NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F1007142	WV
2	363LF0000X	Family Nurse Practitioner	SP016966	PA
3	363LF0000X	Family Nurse Practitioner	APRN34480	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34480	OTHER	WV	WV BOARD OF EXAMINERS

General Provider Information

NPI Number	:	1427386788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY B MCMAHON NP-C

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26506-1200
Country	:	US
Telephone Number	:	877-988-4478
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 CROSSROADS RD STE 201
Second Line	:
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-2458
Country	:	US
Telephone Number	:	844-484-0300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2009
Last Update Date	:	04/21/2022

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