Healthcare Provider Details

I. General information

NPI: 1902385784
Provider Name (Legal Business Name): YASMIN MATHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2018
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR # 3K
DURHAM NC
27710-4000
US

IV. Provider business mailing address

40 DUKE MEDICINE CIR # 3K
DURHAM NC
27710-4000
US

V. Phone/Fax

Practice location:
  • Phone: 919-385-3376
  • Fax:
Mailing address:
  • Phone: 919-385-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9454238
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9454238
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5012512
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: