Individual
CODY WILLIAM MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1404 POMERELLE AVE STE B, BURLEY, ID 83318-2013
(208) 878-9432
(208) 878-9432
Mailing address
1404 POMERELLE AVE STE B, BURLEY, ID 83318-2013
(208) 878-9432
(208) 878-4576
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
60234
ID
Other
Enumeration date
09/21/2021
Last updated
07/28/2025
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