Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP133202 | TX |
NPI | 1043751027 |
---|---|
Provider Name | Frederica D Matzner |
First Address | Azle, TX 76020-3614 |
Second Address | Azle, TX 76020-3614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2017 |
Last Update Date | 10/03/2017 |