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General NPI Number Information
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NPI Number | 1447503842
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Entity Type | Individual
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Provider Name | CHARLENE CROWDER MATTHEWS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 833 W HIGHWAY 25 70 STE D
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City | NEWPORT
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State | TN
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Zip | 37821-8045
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Country | US
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Telephone | 423-720-9111
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Fax | 423-301-5756
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Provider Business Mailing Address
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Address Line | 833 W HIGHWAY 25 70 STE D
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City | NEWPORT
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State | TN
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Zip | 37821-8045
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Country | US
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Telephone | 423-720-9111
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Fax | 423-301-5756
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 16835
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License Number State | TN
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