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NPI Code Detail

MEDICARE: KIMBERLY NOELLE MATTHEWS FNP

MEDICARE: KIMBERLY NOELLE MATTHEWS FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN148719LA
2363LF0000XFamily Nurse PractitionerAP08376LA

General Provider Information

NPI Number : 1003065731
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY NOELLE MATTHEWS FNP
Provider Business Mailing Address
First Line : 8236 PANOLA ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70118-2927
Country : US
Telephone Number : 803-443-8185
Fax Number :
Provider Business Practice Location Address
First Line : 820 W ESPLANADE AVE
Second Line :
City : KENNER
State : LA
Zip : 70065-2757
Country : US
Telephone Number : 504-467-8313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2008
Last Update Date : 11/29/2017

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