Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jessica L Mahoney, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1659836070

Jessica L Mahoney, NURSEPRACTITIONER is a Nurse Practitioner in Saint Paul, Minnesota. Qualified in 2018, 8 years ago. Licensed in Minnesota.

Years since qualifying
8
Licensed in
MN
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

225 Smith Ave N Ste 400
Saint Paul, MN 55102-2568
Phone: (651) 290-0133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 6426 (MN)
Nurse Practitioner Taxonomy 363L00000X · Licence AG02190059 (MN)

Record details

NPI number1659836070
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedFebruary 11, 2019
Last updated in NPPESMarch 11, 2021
Certification dateMarch 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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