Herbert Matanga, CNP
Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent in Rogers, MN. Individual provider (NPI-1).
NPI number1003664525
StatusActive
Last updated in NPPESMay 9, 2024
Details
- NPI
- 1003664525
- Entity type
- Individual (NPI-1)
- Name
- Herbert Matanga
- Credential
- CNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 9, 2024
- Certification date
- May 9, 2024
- Last updated
- May 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 364SP0807X | Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent | 11557 | MN | Yes |
Practice location
19427 136th Ave NRogers, MN 55374-4834
Phone 763-516-4476
Mailing address
19427 136th Ave NRogers, MN 55374-4834
Phone 763-516-4476
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