Individual
REBECCA SUZANNE MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7701 YORK AVE S, SUITE 180, EDINA, MN 55435-5845
(952) 927-7810
(952) 927-6309
Mailing address
7701 YORK AVE S, SUITE 180, EDINA, MN 55435-5845
(952) 927-7810
(952) 927-6309
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
41654
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1362715
AMERICA'S PPO
MN
01
—
142689C626
UCARE
MN
01
—
256L5MA
BLUE CROSS BLUE SHIELD
MN
05
—
279224900
—
MN
01
—
3300003
MEDICA PRIMARY
MN
01
—
3300159
SELECT CARE
MN
01
—
410999025
TRICARE
MN
01
—
960541028184
PREFERRED ONE
MN
01
—
HP33644
HEALTH PARTNERS
MN
Enumeration date
03/25/2006
Last updated
05/06/2008
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