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Organization

CLINIC AT 410 PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRESSA ANTIONETTE MATCHEN NURSE PRACTITIONER (FNP-BC)
(580) 565-9975
Entity
Organization

Contact information

Practice address
410 HWY 70, KINGSTON, OK 73439
(580) 565-9975
(888) 241-2340
Mailing address
410 HIGHWAY 70 W, KINGSTON, OK 73439-8237
(580) 565-9975
(888) 241-2340

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
07/01/2024
Last updated
02/25/2026
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