Individual
NICKOLAS MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1307 CROWLEY RAYNE HWY STE B, CROWLEY, LA 70526-8210
(337) 783-6857
(337) 783-6167
Mailing address
186 GENTRY RD, WASHINGTON, LA 70589-4454
(832) 229-3711
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
215774
LA
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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