Healthcare Provider Details

I. General information

NPI: 1891715454
Provider Name (Legal Business Name): ALEXANDER MACDONALD MATSON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

10147 CERULEAN RD
CERULEAN KY
42215-7519
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-4751
  • Fax: 270-798-5870
Mailing address:
  • Phone: 270-235-0741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2632P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: