Provider Demographics
NPI:1710408182
Name:ALBARADO, MATHEW JOHN (FNP-C)
Entity Type:Individual
Prefix:
First Name:MATHEW
Middle Name:JOHN
Last Name:ALBARADO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 ODD FELLOWS RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2206
Mailing Address - Country:US
Mailing Address - Phone:337-783-7004
Mailing Address - Fax:337-783-0070
Practice Address - Street 1:345 ODD FELLOWS RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526
Practice Address - Country:US
Practice Address - Phone:337-783-7004
Practice Address - Fax:337-783-0070
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily