Individual
MRS. CALEN BRIANA MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, CPNP-PC
Contact information
Practice address
1000 CLYBURN PL, AIKEN, SC 29801-4193
(803) 380-7000
Mailing address
880 CHESHAM AVE, GROVETOWN, GA 30813-5984
(706) 284-9442
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN278836
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN278836
GA
Other
Enumeration date
11/22/2023
Last updated
02/19/2024
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