Individual
MR. MATTHEW STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 393-1912
(270) 393-1913
Mailing address
165 NATCHEZ TRACE AVE, SUITE 205, BOWLING GREEN, KY 42103-7940
(270) 393-1912
(270) 393-1913
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3010955
KY
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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