Matthew, Susan Lynn

Matthew, Susan Lynn is an individual health care provider with primary practice located at 855 Montgomery St , Fort Worth TX 76107-2553. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Matthew, Susan Lynn can be contacted via phone (817) 735-0502.

Contact Information

Primary practice address
855 Montgomery St Fort Worth TX 76107-2553
Phone: (817) 735-0502
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 559909 Texas
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 559909 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 559909 Texas

Profile Details

NPI number 1891031316
LBN Legal business name Matthew, Susan Lynn
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2013
Last updated Jul 14th, 2017 - about 9 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 1891031316 NPPES
Texas MEDICAID 321912302
Texas Other 8565NQ
Texas MEDICAID 321912304
Texas Other 8574NM

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