Individual provider · NPI-1

Lisa Abella Matos, FNP

Nurse Practitioner, Family · Saint Louis, MO

NPI number1760388722
StatusActive
Last updated in NPPESOct 16, 2026

Details

NPI
1760388722
Entity type
Individual (NPI-1)
Name
Lisa Abella Matos
Credential
FNP
Sex
Female
Sole proprietor
No
Enumeration date
Oct 16, 2026
Certification date
Oct 16, 2026
Last updated
Oct 16, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family2026048779MOYes

Practice location

4133 Magnolia Ave Apt 3
Saint Louis, MO 63110-3944

Phone 786-597-4992

Mailing address

4133 Magnolia Ave Apt 3
Saint Louis, MO 63110-3944

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