Individual
MRS. LORRAINE MICHELLE MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 N EL PASO ST, EL PASO, TX 79902-3437
(915) 577-0445
(915) 577-0509
Mailing address
1400 N EL PASO ST STE E, EL PASO, TX 79902-3438
(915) 577-0445
(915) 577-0509
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1039612
TX
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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