MEDICARE: PAULA A MALONEY PNP

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	363LP0200X	Pediatric Nurse Practitioner	104896	CO

General Provider Information

NPI Number	:	1518030998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA A MALONEY PNP

Provider Business Mailing Address
First Line	:	PSC 482 BOX 2874
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96362
Country	:	JP
Telephone Number	:	98-890-0173
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 MDG
Second Line	:
City	:	KADENA AFB
State	:	OKINAWA
Zip	:	96362
Country	:	JP
Telephone Number	:	6437160
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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