Individual
MS. KRISTEN LEE MATULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, AGNP-C
Contact information
Practice address
710 W 168TH ST RM 335, NEW YORK, NY 10032-3726
(972) 978-6478
(212) 305-1304
Mailing address
710 W 168TH ST RM 335, NEW YORK, NY 10032-3726
(972) 978-6478
(212) 305-1304
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310775
NY
363LG0600X
Gerontology Nurse Practitioner
11003829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104216100
—
FL
Enumeration date
08/28/2019
Last updated
04/09/2024
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