MEDICARE: KARLA MATTHEWS

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
1	363L00000X	Nurse Practitioner	250569	LA

General Provider Information

NPI Number	:	1497369706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA MATTHEWS

Provider Business Mailing Address
First Line	:	3710 SOUTH ROCHENBLAVE ST.
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-1003
Country	:	US
Telephone Number	:	504-515-6961
Fax Number	:

Provider Business Practice Location Address
First Line	:	3710 SOUTH ROCHENBLAVE ST.
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-1003
Country	:	US
Telephone Number	:	504-515-6961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	09/05/2020

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Directions to “ KARLA MATTHEWS ” Practice Location

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