Provider Demographics
NPI:1437817939
Name:MATHEW, ALLIN (APRN)
Entity Type:Individual
Prefix:
First Name:ALLIN
Middle Name:
Last Name:MATHEW
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 CREEKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6398
Mailing Address - Country:US
Mailing Address - Phone:972-837-6383
Mailing Address - Fax:
Practice Address - Street 1:11330 LEGACY DR STE 103
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1210
Practice Address - Country:US
Practice Address - Phone:972-837-6383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054869363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty