Individual
ANNA TATIRA MATARUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1147 EBENEZER RD, ROCK HILL, SC 29732-2355
(803) 329-6648
(803) 985-4134
Mailing address
1147 EBENEZER RD, ROCK HILL, SC 29732-2355
(803) 329-6648
(803) 985-4134
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20481
SC
363LF0000X
Family Nurse Practitioner
5014395
NC
Other
Enumeration date
09/22/2016
Last updated
02/05/2024
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