Healthcare Provider Details

I. General information

NPI: 1134937352
Provider Name (Legal Business Name): MATRIKA POKHREL FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 FREEDOM SQUARE DR FL 5
INDEPENDENCE OH
44131-2577
US

IV. Provider business mailing address

6000 FREEDOM SQUARE DR FL 5
INDEPENDENCE OH
44131-2577
US

V. Phone/Fax

Practice location:
  • Phone: 866-686-2504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0039132
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: