Individual
MISS CHARLESETTA MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4602 WALLACE AVE APT 3, KANSAS CITY, MO 64129-2161
(816) 805-6901
Mailing address
4602 WALLACE AVE APT 3, KANSAS CITY, MO 64129-2161
(816) 805-6901
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
105421
MO
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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