Provider Demographics
NPI:1144013863
Name:MAHAN, REAGAN
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:
Last Name:MAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:
Other - Last Name:MAHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1391 BUFFALO RUN RD
Mailing Address - Street 2:
Mailing Address - City:CALHAN
Mailing Address - State:CO
Mailing Address - Zip Code:80808-7860
Mailing Address - Country:US
Mailing Address - Phone:315-529-2294
Mailing Address - Fax:
Practice Address - Street 1:1391 BUFFALO RUN RD
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-7860
Practice Address - Country:US
Practice Address - Phone:315-529-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula