Individual
COURTNEY R MATKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
145 W 23RD ST STE 202, ERIE, PA 16502-2858
(814) 452-5081
(814) 452-7918
Mailing address
145 W 23RD ST STE 202, ERIE, PA 16502-2858
(814) 452-5081
(814) 452-7918
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP014832
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030224520002
—
PA
Enumeration date
04/10/2015
Last updated
10/05/2020
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