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General NPI Number Information
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NPI Number | 1528666724
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Entity Type | Individual
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Provider Name | KRISTI M MATHENY-LONG RN CASE MANAGER
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Gender | Female
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | MAIN STREET
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City | RILEY
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State | WV
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Zip | 25271
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Country | US
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Telephone | 304-373-1456
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Fax | 304-373-1330
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Provider Business Mailing Address
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Address Line | PO BOX 697
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City | RIPLEY
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State | WV
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Zip | 25271-0697
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Country | US
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Telephone | 304-373-1456
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Fax | 304-373-1330
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 50916
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License Number State | WV
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