Individual
THERESE L MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLP
Contact information
Practice address
985459 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5459
(402) 559-8643
Mailing address
985459 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5459
(402) 559-8643
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
316
NE
363LP0200X
Pediatric Nurse Practitioner
Primary
105079
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
105079
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025287200
—
NE
05
—
470855757
—
NE
Enumeration date
10/09/2007
Last updated
11/20/2008
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