DEBRA SUE MAHONEY (NPI# 1265619241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265619241 |
| Entity Type | Individual |
| Full Name | DEBRA SUE MAHONEY |
| Credential | FNP |
| Practice Address |
1600 Broadway Ave Gladewater TX 75647-5040 |
| Mailing Address |
Po Box 4207 Longview TX 75606-4207 |
| Practice Telephone | 9033155630 |
| Practice Fax Number | 9038456212 |
| Mailing Telephone | 9033154105 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2016-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP109268 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750850111 | Debra Spano Mahoney | Technician/Technologist | 2201 S 10th St, Fort Pierce, FL 34950-5382 | 2018-11-15 |
| 1669720876 | Debra M Mahoney | Social Worker | 51 Childrens Way, Enterprise, FL 32725-8135 | 2012-08-17 |
| 1851697718 | Debra Robin Mahoney | Social Worker | 600 S Commonwealth Ave, 2nd Floor, Los Angeles, CA 90005-4001 | 2011-02-09 |
| Street Address |
1600 BROADWAY AVE |
| City | GLADEWATER |
| State | TX |
| Zip Code | 75647-5040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053316711 | Kenneth H. Skipper | Family Medicine | 1600 Broadway Ave, Gladewater, TX 75647-5040 | 2005-06-17 |
| 1093172785 | Tracy Casey | Nurse Practitioner | 1600 Broadway Ave, Gladewater, TX 75647 | 2016-01-26 |
| 1720408909 | Joseph G. Carver | Family Medicine | 1600 Broadway Ave, Gladewater, TX 75647-5040 | 2014-04-26 |
| 1528075124 | Lynn Karin Jennings | Family Medicine | 1600 Broadway Ave, Gladewater, TX 75647-5040 | 2006-08-03 |
| 1356399406 | Gs Physician Services | Internal Medicine | 1600 Broadway Ave, Gladewater, TX 75647-5040 | 2006-05-04 |
| 1275538019 | William Hollas | Family Medicine | 1600 Broadway Ave, Gladewater, TX 75647-5040 | 2005-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316559321 | B &g Custom Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1088 Willow Oak Rd, Gladewater, TX 75647 | 2020-08-20 |
| 1578866182 | Easttexrx LLC | Pharmacy | 402b W Upshur, Gladewater, TX 75647 | 2010-12-21 |
| 1518173285 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 2402 Woodbine, Gladwater, TX 75647 | 2007-05-16 |
| 1407921638 | Michael Ray Ellis | Dentist | 406 West Upshur Ave, Gladewater, TX 75647 | 2006-11-22 |
| 1811087356 | Walker Pharmacy | Pharmacy | 402 B W Upshur, Gladewater, TX 75647 | 2006-10-13 |
| 1508953399 | Legend Healthcare Gladewater, Lp | Skilled Nursing Facility | 1201 Fm 2685, Gladewater, TX 75647 | 2006-10-05 |
| 1720033517 | L-m-r Health Care Services Inc | Intermediate Care Facility, Mentally Retarded | 502 Tenery St, Gladewater, TX 75647 | 2006-05-23 |
| 1851434237 | Union Grove Isd | Local Education Agency (LEA) | Old Hwy 271 S, Gladewater, TX 75647-1447 | 2007-02-15 |
| 1164957692 | Jolene Ackley | Private Vehicle | 500 W Marshall Ave, Gladewater, TX 75647-2110 | 2017-04-21 |
| 1518986959 | Juan Raul Zapata | Family Medicine | 307 W Upshur Ave, Gladewater, TX 75647-2121 | 2006-07-18 |
| Find all providers in zip 75647 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447813449 | Cassandra Ford | Nurse Practitioner | 307 W Upshur Ave, Gladewater, TX 75647-2121 | 2019-04-16 |
| 1093172785 | Tracy Casey | Nurse Practitioner | 1600 Broadway Ave, Gladewater, TX 75647 | 2016-01-26 |
| 1497050306 | Linus Scott Medley | Nurse Practitioner | 307 W Upshur Ave, Gladewater, TX 75647-2121 | 2011-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255162 | Shaida Rahmatinick | Nurse Practitioner | 1515 W 22nd St, Houston, TX 77008-1501 | 2020-11-08 |
| 1891396586 | Stacey Lynne Ready | Nurse Practitioner | 200 Uptmore Rd, West, TX 76691-2339 | 2020-11-08 |
| 1992306609 | Jillian Mcclintock | Nurse Practitioner | 2506 Graystone Ln, Corinth, TX 76210-1607 | 2020-11-08 |
| 1851992515 | Stacie A Gregg | Nurse Practitioner | 1229 Johnny Ln, San Angelo, TX 76905-2331 | 2020-11-07 |
| 1285235929 | Activate Family Health, Pllc | Nurse Practitioner | 203 E Davis St Ste F-1026, Conroe, TX 77301-3159 | 2020-11-07 |
| 1629679782 | Kristen Aili Johnson | Nurse Practitioner | 3850 Fm 18, Abilene, TX 79602-2004 | 2020-11-05 |
| 1376144303 | Stephanie Renee Knight | Nurse Practitioner | 4326 Egret Dr, Seabrook, TX 77586-2557 | 2020-11-05 |
| 1457952319 | Olufunke Oyindamola Oshoba | Nurse Practitioner | 200 Odyssey Ln, Mansfield, TX 76063-3438 | 2020-11-05 |
| 1518568419 | Ian Mardis | Nurse Practitioner | 12528 Tierra Encino Dr, El Paso, TX 79938-4525 | 2020-11-05 |
| 1851992994 | Angela Davis | Nurse Practitioner | 9523 Scanlan Heights Ln, Missouri City, TX 77459-5503 | 2020-11-05 |
| Find all providers with the same taxonomy | ||||
| City | GLADEWATER |
| Zip Code | 75647 |
Please comment or provide details below to improve the information on DEBRA SUE MAHONEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.