Matthews, Mikklena M

Matthews, Mikklena M is an individual health care provider with primary practice located at 1898 Fort Rd , Sheridan WY 82801-8320. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Matthews, Mikklena M can be contacted via phone (307) 672-3473.

Contact Information

Primary practice address
1898 Fort Rd Sheridan WY 82801-8320
Phone: (307) 672-3473
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X AP3293 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1146 Wyoming

Profile Details

NPI number 1821170051
LBN Legal business name Matthews, Mikklena M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Sep 14th, 2021 - about 3 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 1821170051 NPPES
Iowa Other 39258 BCBSNE FOR IOWA
Iowa MEDICAID 100251147-00 BCBSNE FOR IOWA
Iowa Other 254537 BCBSNE FOR IOWA
Iowa Other 39139 BCBSNE FOR IOWA
Iowa Other 254537 BCBSNE FOR IOWA

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