Individual
MS. KRISTEN MALIBU MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4513 EDWARDS MILL RD, SUITE H, RALEIGH, NC 27612-3779
(252) 646-6847
Mailing address
4513 EDWARDS MILL RD, SUITE H, RALEIGH, NC 27612-3779
(252) 646-6847
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
246277
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246277
NC NURSING LICENSE
NC
Enumeration date
04/02/2015
Last updated
04/02/2015
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