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General NPI Number Information
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NPI Number | 1780518902
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Entity Type | Individual
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Provider Name | NATHAN JORDAN MATTHEWS RN
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Gender | Male
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-0002
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Country | US
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Telephone | 480-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 93 GRANDE ISLE AVE SW UNIT 2512
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City | ROCHESTER
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State | MN
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Zip | 55902-3545
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Country | US
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Telephone | 515-509-5773
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 2476099
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License Number State | MN
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