Provider Demographics
NPI:1881637304
Name:MATTHEWS, SUSAN G (NPC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:G
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
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Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2361
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 309
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-383-0165
Practice Address - Fax:615-292-4657
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN13506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6064323OtherBCBST
TNQ021969Medicaid
TN6064323OtherBCBST