Healthcare Provider Details

I. General information

NPI: 1558731562
Provider Name (Legal Business Name): MATTHEW EHMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

788 WASHINGTON RD
PITTSBURGH PA
15228-2021
US

IV. Provider business mailing address

333 COMMERCE ST STE 700
NASHVILLE TN
37201-1826
US

V. Phone/Fax

Practice location:
  • Phone: 412-307-4609
  • Fax:
Mailing address:
  • Phone: 615-454-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN535735
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP015540
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP015540
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP015540
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: