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General NPI Number Information
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NPI Number | 1023079977
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Entity Type | Individual
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Provider Name | CHERYL ANN MATCHEN R.N.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | W2892 KRUEGER RD
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City | LAKE GENEVA
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State | WI
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Zip | 53147-2755
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Country | US
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Telephone | 608-206-0859
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Fax |
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Provider Business Mailing Address
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Address Line | W2892 KRUEGER RD
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City | LAKE GENEVA
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State | WI
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Zip | 53147-2755
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Country | US
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Telephone | 608-206-0859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 114865-030
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License Number State | WI
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