Individual
ANGELA MATHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-4568
(763) 427-9980
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1781
MN
363LA2200X
Adult Health Nurse Practitioner
A0712012
MN
363LG0600X
Gerontology Nurse Practitioner
G0712002
MN
Other
Enumeration date
07/18/2012
Last updated
09/28/2022
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