Provider Demographics
NPI:1659610400
Name:CUTLER, MATTHEW TODD (LVN)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:TODD
Last Name:CUTLER
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 W HUNT ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-5147
Mailing Address - Country:US
Mailing Address - Phone:817-262-0414
Mailing Address - Fax:
Practice Address - Street 1:1126 W HUNT ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-5147
Practice Address - Country:US
Practice Address - Phone:817-262-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229065164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse