Individual
DEBORAH L MATOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2912 SPRINGBORO W, SUITE 201, MORAINE, OH 45439-1674
(937) 297-8999
(937) 233-1965
Mailing address
2337 SUGAR RIDGE LN, CENTERVILLE, OH 45458-2862
(937) 297-8999
(937) 233-1965
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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