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General NPI Number Information
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NPI Number | 1467389056
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Entity Type | Individual
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Provider Name | RAELENE MATTSON
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Gender | Female
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 105 GARFIELD AVENUE COLLEGE OF NURSING
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4800
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Country | US
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Telephone | 715-836-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 70620 HOOVER LINE RD
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City | IRON RIVER
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State | WI
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Zip | 54847-5011
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Country | US
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Telephone |
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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 | 232119-30
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License Number State | WI
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