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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891031316 | NPPES |
| Texas | MEDICAID | 321912302 | |
| Texas | Other | 8565NQ | |
| Texas | MEDICAID | 321912304 | |
| Texas | Other | 8574NM |
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