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General NPI Number Information
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NPI Number | 1740801588
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Entity Type | Individual
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Provider Name | MATILDAH A MCHATTA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 18 MDG UNIT 5268
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City | APO
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State | AP
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Zip | 96368-5217
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Country | US
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Telephone | 544-634-3272
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Fax |
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Provider Business Mailing Address
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Address Line | 18 MDG UNIT 5268 OPC 80 BOX 5217
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City | APO
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State | AP
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Zip | 96368-5217
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61327117
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License Number State | WA
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