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NPI Code Detail

MEDICARE: ELIZABETH L MATHEWSON NP

MEDICARE: ELIZABETH L MATHEWSON NP
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 Practitioner4704249800NSA2002SMI

General Provider Information

NPI Number : 1487286688
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH L MATHEWSON NP
Provider Business Mailing Address
First Line : 605 W CHICAGO RD
Second Line :
City : COLDWATER
State : MI
Zip : 49036-8400
Country : US
Telephone Number : 179-241-4455
Fax Number :
Provider Business Practice Location Address
First Line : 2900 WATKINS RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-8604
Country : US
Telephone Number : 269-245-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2020
Last Update Date : 03/13/2023

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