Individual
CAROL MATTHYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2021 CENEX DR, SUITE J, RICE LAKE, WI 54868-1891
(715) 234-7246
Mailing address
2021 CENEX DR, SUITE J, RICE LAKE, WI 54868-1891
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1944
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43952100
—
WI
Enumeration date
09/20/2006
Last updated
06/05/2010
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