Kristen Lee Matulis
Nurse Practitioner - Gerontology
10150 Highland Manor Dr Ste 240
Tampa
, Florida 33610-9750
Kristen Lee Matulis
Nurse Practitioner - Gerontology
10150 Highland Manor Dr Ste 240
Tampa
, Florida 33610-9750
(813) 254-0396
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Kristen Lee Matulis
- 10150 Highland Manor Dr Ste 240
- Tampa, FL
- Zip : 33610-9750
- Fax : (813) 254-0396
- Phone : (813) 259-1013
Second Address
- Kristen Lee Matulis
- 10150 Highland Manor Dr Ste 240
- Tampa, FL
- Zip : 33610-9750
- Phone : (813) 259-1013
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Is Kristen Lee Matulis a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 11003829 | FL |
National Provider Identifier
| NPI | 1033767587 |
|---|---|
| Provider Name | Kristen Lee Matulis |
| First Address | Tampa, FL 33610-9750 |
| Second Address | Tampa, FL 33610-9750 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/08/2019 |
| Last Update Date | 14/12/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 104216100 | (05) | FL |
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.