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General NPI Number Information
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NPI Number | 1902653595
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Entity Type | Individual
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Provider Name | DOLLY MATHENY RN
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Gender | Female
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Dates
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Enumeration Date | 05/02/2024
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 2460 JACKSON PIKE
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City | COLUMBUS
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State | OH
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Zip | 43223-3847
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Country | US
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Telephone | 614-525-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 7846 LUHRIG RD
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City | ATHENS
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State | OH
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Zip | 45701-9195
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Country | US
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Telephone | 614-403-4231
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.457476
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License Number State | OH
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