Provider Demographics
NPI:1891482576
Name:MATTERN, DARREN MICHAEL (RN)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:MICHAEL
Last Name:MATTERN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 MANOR DR STE 10
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4917
Mailing Address - Country:US
Mailing Address - Phone:814-943-2273
Mailing Address - Fax:
Practice Address - Street 1:2891 FAIRWAY DRIVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601
Practice Address - Country:US
Practice Address - Phone:814-943-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN710222163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse