Individual
TERESA MICHELLE MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6400 DUTCHMANS PKWY STE 250, LOUISVILLE, KY 40205-3354
(502) 587-9660
Mailing address
4119 NACHAND LN, LOUISVILLE, KY 40218-2841
(502) 439-2396
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3013645
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3013645
KENTUCKY BOARD OF NUR
KY
Enumeration date
07/20/2019
Last updated
11/27/2023
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