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Individual

DEBORAH L MATOSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP01598
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000638084
BCBS-OH
OH
05
2050435
OH
01
421534506159
CARESOURCE
OH
Enumeration date
06/06/2006
Last updated
09/09/2020
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