Individual
KERRI H. MATHIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
101 JEREMIAH V SULLIVAN DR, FALL RIVER, MA 02721-6812
(508) 672-0107
Mailing address
63 GRETCHEN WAY, RAYNHAM, MA 02767-5163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
239
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
239
STATE PA LICENSE
MA
Enumeration date
03/20/2007
Last updated
07/08/2007
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