NPI 1043863079
Jenny Lee Mahoney, IDC
Practice location
- Address
- 55281 Yellow Jacket Dr, Callahan, FL 32011-8534
- Phone
- (757) 672-8533
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1043863079
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 18 Jul 2019
- Record last updated
- 7 Jan 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.