Individual
ALLYSON NICOLE MATTHESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5000
(573) 632-5876
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2023001731
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220129220
—
MO
Enumeration date
02/20/2023
Last updated
01/30/2024
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