Individual
JEFFERY CARL MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
810 FAIRGROVE CHURCH ROAD, HICKORY, NC 28602-9617
(828) 326-3809
(828) 326-3371
Mailing address
PO BOX 890041, CHARLOTTE, NC 28289-0041
(828) 326-3809
(828) 326-3371
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
122324
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
053776
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052034
—
NC
Enumeration date
08/22/2005
Last updated
10/27/2020
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