Provider Demographics
NPI:1235547589
Name:MATTHEWS, TAMELA C (ARNP)
Entity Type:Individual
Prefix:
First Name:TAMELA
Middle Name:C
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 PERSHING HWY
Mailing Address - Street 2:
Mailing Address - City:SMACKOVER
Mailing Address - State:AR
Mailing Address - Zip Code:71762-9542
Mailing Address - Country:US
Mailing Address - Phone:870-725-4392
Mailing Address - Fax:
Practice Address - Street 1:1856 PERSHING HWY
Practice Address - Street 2:
Practice Address - City:SMACKOVER
Practice Address - State:AR
Practice Address - Zip Code:71762-9542
Practice Address - Country:US
Practice Address - Phone:870-725-4392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily