Individual
TRACEY RENEE MATTIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
159 E 3RD ST, EDGARD, LA 70049-2450
(985) 497-8726
(985) 497-3108
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06635
LA
Other
Enumeration date
10/12/2011
Last updated
11/15/2018
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