Individual
MRS. CARRIE KATHLEEN MATTIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
209 E 3RD ST, SALIDA, CO 81201-2614
(719) 539-4510
(719) 539-7197
Mailing address
209 E 3RD ST, SALIDA, CO 81201-2614
(719) 539-4510
(719) 539-7197
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
115068
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04419099
—
CO
Enumeration date
04/14/2008
Last updated
04/14/2008
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