Provider Demographics
NPI:1942574819
Name:MATHEWS, KRISTIN ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24200 N ALMA SCHOOL RD
Mailing Address - Street 2:LOT 48
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3000
Mailing Address - Country:US
Mailing Address - Phone:602-320-3197
Mailing Address - Fax:480-502-0099
Practice Address - Street 1:24200 N ALMA SCHOOL RD
Practice Address - Street 2:LOT 48
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3000
Practice Address - Country:US
Practice Address - Phone:602-320-3197
Practice Address - Fax:480-502-0099
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN075330163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse