Nelson, Matthew R

Nelson, Matthew R is an individual health care provider with primary practice located at 2375 E Sunnyside Rd Ste J , Idaho Falls ID 83404-8281. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Nelson, Matthew R can be contacted via phone (208) 522-7246.

Contact Information

Primary practice address
2375 E Sunnyside Rd Ste J Idaho Falls ID 83404-8281
Phone: (208) 522-7246
Fax: (208) 529-2620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA540 Idaho

Profile Details

NPI number 1649221912
LBN Legal business name Nelson, Matthew R
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Oct 15th, 2014 - about 10 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 1649221912 NPPES
Idaho MEDICAID 807285000

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