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NPI Code Detail

MEDICARE: MORGAN MCKENZIE MATLICK CNP

MEDICARE: MORGAN MCKENZIE MATLICK CNP
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
1363LA2100XAcute Care Nurse PractitionerAPRN.CNP.0035179OH
2363LC0200XCritical Care Medicine Nurse PractitionerAPRN.CNP.0035179OH
3363L00000XNurse PractitionerAPRN.CNP.0035179OH

General Provider Information

NPI Number : 1588446736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN MCKENZIE MATLICK CNP
Provider Business Mailing Address
First Line : 2426 VALLEY VIEW LN
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-8851
Country : US
Telephone Number : 330-447-1194
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-541-1758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2023
Last Update Date : 10/20/2023

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