Davika Jon Kuper Mattox
Nurse Practitioner - Psychiatric/Mental Health
321 E Main St
Morehead
, Kentucky 40351-1671
Davika Jon Kuper Mattox
Nurse Practitioner - Psychiatric/Mental Health
321 E Main St
Morehead
, Kentucky 40351-1671
(606) 329-8195
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Davika Jon Kuper Mattox
- Po Box 790
- Ashland, KY
- Zip : 41105-0790
- Fax : (606) 329-8195
- Phone : (606) 329-8588
Second Address
- Davika Jon Kuper Mattox
- 321 E Main St
- Morehead, KY
- Zip : 40351-1671
- Fax : (606) 783-9952
- Phone : (606) 784-4161
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Is Davika Jon Kuper Mattox a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3008791 | KY |
National Provider Identifier
| NPI | 1013045137 |
|---|---|
| Provider Name | Davika Jon Kuper Mattox |
| First Address | Ashland, KY 41105-0790 |
| Second Address | Morehead, KY 40351-1671 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/03/2007 |
| Last Update Date | 11/01/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000560517 | ANTHEM BCBS (01) | |
| 30610026 | (05) | KY |
| 7100317090 | (05) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.