Individual
JESSICA RAY MATKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 6TH ST S, ST PETERSBURG, FL 33701-4814
(727) 823-2188
(727) 828-0723
Mailing address
PO BOX 22005, ST PETERSBURG, FL 33742-2005
(727) 823-2188
(727) 828-0723
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP 9168845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308608900
—
FL
01
—
59-3411711
GTBA
FL
01
—
593072468
BAYFRONT ANESTHESIA SERVICES PA
FL
01
—
G4357
BLUE CROSS BLUE SHEILD
FL
Enumeration date
06/20/2007
Last updated
08/30/2011
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