Individual
PROF. ANNIE MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4218 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1625
(702) 885-7185
Mailing address
4218 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1625
(702) 885-7185
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN001223
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346544061
—
NV
Enumeration date
01/10/2011
Last updated
02/23/2016
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