Provider Demographics
NPI:1013637404
Name:MATTHEWS, OPHELIA OSINACHI (APN)
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:OSINACHI
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:OPHELIA
Other - Middle Name:OSINACHI
Other - Last Name:OKEBAGTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:252 CO RD 601 BELLE MEAD
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502
Mailing Address - Country:US
Mailing Address - Phone:908-281-1000
Mailing Address - Fax:
Practice Address - Street 1:13 PATTON DR
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2533
Practice Address - Country:US
Practice Address - Phone:267-608-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01347600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health