Individual
MS. PETRONELA TRINA MATIUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3545 WHITEHALL PARK DR STE 300, CHARLOTTE, NC 28273-4179
(704) 316-6187
(704) 316-6217
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5009780
NC
363LF0000X
Family Nurse Practitioner
5009780
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5009780
NC BOARD OF NURSING
NC
01
—
F07170966
AANP
—
Enumeration date
08/14/2017
Last updated
10/26/2020
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