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Individual

MRS. VONDA BROCK MATTINGLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
10 DEARBORN RD, PEABODY, MA 01960-8836
(978) 998-6821
Mailing address
10 DEARBORN RD, PEABODY, MA 01960-8836
(978) 998-6821

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1102923
KY
363LF0000X
Family Nurse Practitioner
Primary
3009289
KY

Other

Enumeration date
03/05/2015
Last updated
12/09/2020
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