Individual
MATTHEW A ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
1526 30TH ST NW, BEMIDJI, MN 56601-4140
(218) 209-7528
Mailing address
1526 30TH ST NW, BEMIDJI, MN 56601-4140
(218) 209-7528
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R-186703-5
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12156
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12156
CERTIFIED NURSE PRACTITIONER
MN
Enumeration date
03/24/2011
Last updated
07/21/2025
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