Provider Demographics
NPI:1003641374
Name:MATHES, MEGHAN (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:MATHES
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 38TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5572
Mailing Address - Country:US
Mailing Address - Phone:406-750-1326
Mailing Address - Fax:
Practice Address - Street 1:500 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-3352
Practice Address - Country:US
Practice Address - Phone:406-750-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-242566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine