Matis, Jessica Lynn

Matis, Jessica Lynn is an individual health care provider with primary practice located at Goodwin House 3440 S. Jefferson Street, Baileys Crossroads VA 22041-2204. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Matis, Jessica Lynn can be contacted via phone (703) 820-1488.

Contact Information

Primary practice address
Goodwin House 3440 S. Jefferson Street Baileys Crossroads VA 22041-2204
Phone: (703) 820-1488
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 3010039 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 3010039 Kentucky

Profile Details

NPI number 1093164402
LBN Legal business name Matis, Jessica Lynn
Credentials DNP, APRN, ACNP-AG
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2016
Last updated Aug 15th, 2019 - about 7 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 1093164402 NPPES
Indiana MEDICAID 201391850
Indiana Other 50112260
Indiana Other 0000001021475
Indiana Other 215034
Indiana MEDICAID 7100415610

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