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Individual
THERESA J MATTHEWS
Active
Individual
THERESA J MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-049084
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136138
—
AL
05
—
136244
—
AL
05
—
136246
—
AL
01
—
51122650
BLUE CROSS BLUE SHIELD
AL
01
—
51122652
BLUE CROSS BLUE SHIELD
AL
01
—
51122654
BLUE CROSS BLUE SHIELD
AL
01
—
51122655
BLUE CROSS BLUE SHIELD
AL
01
—
51122664
BLUE CROSS BLUE SHIELD
AL
01
—
5112653
BLUE CROSS BLUE SHIELD
AL
01
—
630760576008
TRICARE
AL
Enumeration date
10/03/2006
Last updated
02/11/2013
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