Provider Demographics
NPI:1790112845
Name:MATERO, HANNE MARI (MMS, PA-C)
Entity type:Individual
Prefix:
First Name:HANNE
Middle Name:MARI
Last Name:MATERO
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2340 E TRINITY MILLS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1946
Mailing Address - Country:US
Mailing Address - Phone:972-417-8937
Mailing Address - Fax:972-439-1977
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 231
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5649
Practice Address - Country:US
Practice Address - Phone:480-945-3873
Practice Address - Fax:817-666-3873
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ5550363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ161839Medicare PIN