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Individual
MIRRIAM C MATULULA
Active
Individual
MIRRIAM C MATULULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
2019050903
PA
363LF0000X
Family Nurse Practitioner
Primary
F10210486
PA
Other
Enumeration date
02/18/2022
Last updated
02/18/2022
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