Provider Demographics
NPI:1982075313
Name:VASEY, MATTHEW JOSEPH
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:VASEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 KING ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3419
Mailing Address - Country:US
Mailing Address - Phone:608-898-4818
Mailing Address - Fax:608-305-8730
Practice Address - Street 1:221 KING ST STE 101
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3419
Practice Address - Country:US
Practice Address - Phone:608-898-4818
Practice Address - Fax:608-307-8730
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013380041399484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily