Provider Demographics
NPI:1669835872
Name:MATEWE, LAUREN (MS,RN,FNP-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MATEWE
Suffix:
Gender:F
Credentials:MS,RN,FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:MATEWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:5005 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402
Mailing Address - Country:US
Mailing Address - Phone:903-455-3500
Mailing Address - Fax:903-455-3509
Practice Address - Street 1:5005 LIVE OAK
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402
Practice Address - Country:US
Practice Address - Phone:903-455-3500
Practice Address - Fax:903-455-3509
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130495363LF0000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily