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NPI Code Detail

MEDICARE: MS. KIM MATTHEWS FNP

MEDICARE: MS. KIM 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
1163WG0000XGeneral Practice Registered Nurse110176NE

General Provider Information

NPI Number : 1265583207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIM MATTHEWS FNP
Provider Business Mailing Address
First Line : 21 RACHEL LANE
Second Line : POB 107
City : BREVIG MISSION
State : AK
Zip : 99785
Country : US
Telephone Number : 907-642-2307
Fax Number :
Provider Business Practice Location Address
First Line : 21 RACHEL LANE
Second Line :
City : BREVIG MISSION
State : AK
Zip : 99785
Country : US
Telephone Number : 907-642-2307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 05/15/2008

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Directions to “ MS. KIM MATTHEWS FNP” Practice Location

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