Individual
KATHLEEN J MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
491 N KNIK ST, WASILLA, AK 99654-7049
(907) 376-9500
(907) 376-9507
Mailing address
491 N KNIK ST, WASILLA, AK 99654-7049
(907) 376-9500
(907) 376-9507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
407
AK
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
407
AK
Other
Enumeration date
07/24/2006
Last updated
07/27/2007
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