Provider Demographics
NPI:1861443681
Name:MATTHEWS, CAROL A (FNP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6825 ADOLPHIA DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-5012
Mailing Address - Country:US
Mailing Address - Phone:760-431-2603
Mailing Address - Fax:858-822-4438
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:MC 8201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:858-822-4332
Practice Address - Fax:619-543-3183
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233033/6267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily