Trevor Samuel Mattarella, FNP
Nurse Practitioner, Family in Pigeon, MI. Individual provider (NPI-1).
NPI number1104337344
StatusActive
Last updated in NPPESMar 26, 2021
Details
- NPI
- 1104337344
- Entity type
- Individual (NPI-1)
- Name
- Mr. Trevor Samuel Mattarella
- Credential
- FNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 16, 2017
- Certification date
- Mar 26, 2021
- Last updated
- Mar 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 4704285057 | MI | Yes |
Practice location
168 N Caseville RdPigeon, MI 48755-9415
Phone 989-453-2141 · Fax 989-453-2559
Mailing address
168 N Caseville RdPigeon, MI 48755-9415
Phone 989-453-2141 · Fax 989-453-2559
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