Individual
CRIS ANN MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
240 MINNESOTA ST, RAPID CITY, SD 57701-6200
(605) 718-5123
(605) 719-9509
Mailing address
240 MINNESOTA ST, RAPID CITY, SD 57701-6200
(605) 718-5123
(605) 719-9509
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0278
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6822032
—
SD
Enumeration date
05/31/2006
Last updated
01/20/2011
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