Individual
MATTHEW EILERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2250
Mailing address
PO BOX 18667, ERLANGER, KY 41018-0667
(859) 572-3617
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1175148
KY
363L00000X
Nurse Practitioner
Primary
3017048
KY
363LF0000X
Family Nurse Practitioner
3017048
KY
Other
Enumeration date
11/17/2021
Last updated
12/19/2022
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