Individual
NATHANIEL MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7500 MERCY RD, OMAHA, NE 68124-2319
(402) 398-6060
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-1036
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
335094
LA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
37438
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2021
Last updated
05/19/2026
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