Individual
MATTHEW ALLEN HUSSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-C
Contact information
Practice address
7150 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1695
(317) 621-4900
Mailing address
575 LEXINGTON AVE, NEW YORK, NY 10022-6102
(212) 746-1664
(212) 746-4888
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28213561A
IN
363LG0600X
Gerontology Nurse Practitioner
311191
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
71010218A
IN
Other
Enumeration date
07/13/2020
Last updated
09/19/2024
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