Individual
MRS. MARIAN ANN MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, PMHNP, RN
Contact information
Practice address
550 W CHALMERS AVE, YOUNGSTOWN, OH 44511-1576
(330) 797-0070
Mailing address
527 N MERIDIAN RD, YOUNGSTOWN, OH 44509-1227
(330) 797-0070
(330) 797-9146
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.330047
OH
163W00000X
Registered Nurse
RN757290
PA
2084P0802X
Addiction Psychiatry Physician
COA13427NP
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.13427
OH
363L00000X
Nurse Practitioner
COA.13427.NP
OH
363LA2200X
Adult Health Nurse Practitioner
APRN.CNP.13427
OH
363LA2200X
Adult Health Nurse Practitioner
SP026529
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN.CNP.13427
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP026528
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082611
—
OH
01
—
12428078
CAQH
OH
Enumeration date
08/13/2012
Last updated
01/09/2023
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