Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP08376 | LA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN148719 | LA |
NPI | 1003065731 |
---|---|
Provider Name | Kimberly Noelle Matthews |
First Address | New Orleans, LA 70118-2927 |
Second Address | Kenner, LA 70065-2757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 29/11/2017 |