Individual
HERBERT MATANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
19427 136TH AVE N, ROGERS, MN 55374-4834
(763) 516-4476
Mailing address
19427 136TH AVE N, ROGERS, MN 55374-4834
(763) 516-4476
Taxonomy
Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
11557
MN
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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