Provider Demographics
NPI:1841657798
Name:STILLION, MATTHEW ROD ALLEN (DNP, PMHNP-C, FNP-C)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ROD ALLEN
Last Name:STILLION
Suffix:
Gender:M
Credentials:DNP, PMHNP-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 NAVARRE ST
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66533-9647
Mailing Address - Country:US
Mailing Address - Phone:785-260-1768
Mailing Address - Fax:
Practice Address - Street 1:125 NAVARRE ST
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66533-9647
Practice Address - Country:US
Practice Address - Phone:785-260-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-23
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45723363LF0000X, 363LP0808X
FLTPAN1193363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily