Individual
MRS. SHANNEL MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-9612
Mailing address
9229 LAKESIDE ST, TIPP CITY, OH 45371-2595
(915) 309-3968
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
71203
HI
163W00000X
Registered Nurse
71787
NM
363LW0102X
Women's Health Nurse Practitioner
Primary
95013479
CA
Other
Enumeration date
03/09/2015
Last updated
05/18/2022
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