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General NPI Number Information
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NPI Number | 1003614074
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Entity Type | Organization
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Legal Business Name | MATHEWS FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 416 N MAIN ST STE F
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City | CAVE CITY
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State | AR
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Zip | 72521-9008
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Country | US
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Telephone | 870-283-9746
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Fax | 870-634-2098
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Provider Business Mailing Address
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Address Line | PO BOX 175
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City | CAVE CITY
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State | AR
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Zip | 72521-0175
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Country | US
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Telephone |
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Fax | 870-634-2098
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Authorized Official
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Title or Position | APRN-CNP, PMHNP-BC
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Name | CAROL GENE MATHEWS
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Credential |
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Telephone | 870-283-9746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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