Matamoros, Kathilee J

Matamoros, Kathilee J is an individual health care provider with primary practice located at 6820 Nw 23Rd St , Bethany OK 73008-5217. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Matamoros, Kathilee J can be contacted via phone (405) 495-5154.

Contact Information

Primary practice address
6820 Nw 23Rd St Bethany OK 73008-5217
Phone: (405) 495-5154
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X TLRN039071 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X SP012283 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X SP012283 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 90694 Oklahoma

Profile Details

NPI number 1508128158
LBN Legal business name Matamoros, Kathilee J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2012
Last updated Apr 13th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508128158 NPPES
Oklahoma MEDICAID 200526530A

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