TRACY K MATALON (NPI# 1174707442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174707442 |
Entity Type | Individual |
Full Name | TRACY K MATALON |
Credential | MSN, FNP |
Practice Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
Mailing Address |
1600 N Rose Ave Oxnard CA 93030-3722 |
Practice Telephone | 2083675189 |
Practice Fax Number | 2083615180 |
Mailing Telephone | 8059882663 |
Enumeration Date | 2007-12-21 |
Last Update Date | 2011-04-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
NP-849A | ID | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3340 E GOLDSTONE WAY |
City | MERIDIAN |
State | ID |
Zip Code | 83642-1026 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306157862 | Samantha Ray Hickey | Nurse Practitioner | 3340 E Goldstone Way, Meridian, ID 83642-1026 | 2010-06-29 |
1265698492 | Hala Gamal Rafla | Physician Assistant | 3340 E Goldstone Way, Meridian, ID 83642-1026 | 2008-08-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
Find all providers in zip 83642 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891328340 | U Matter LLC | Nurse Practitioner | 2440 N Hills St Ste 126, Meridian, MS 39305-2634 | 2020-02-12 |
1609808328 | Nancy Nuce Taylor | Nurse Practitioner | 3525 E Louise Dr Ste 500, Meridian, ID 83642-6305 | 2006-07-06 |
1790325124 | Nancy Lynn Brown | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2020-01-14 |
1922521103 | Courtney T Adkins | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2017-07-19 |
1861924151 | Aimee' Marie Brooks | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2017-03-28 |
1679995112 | Hazel Leann Sullivan | Nurse Practitioner | 1314 19th Ave, Meridian, MS 39301-4116 | 2014-01-18 |
1790933752 | Jessica S. Vaughan | Nurse Practitioner | 1314 19th Ave, Meridian, MS 39301-4116 | 2008-09-03 |
1912981085 | Bonnie E. Earley | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2005-12-02 |
1013999838 | Patti Suzanne Weaver | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2005-11-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629685235 | Mark Mitchell Roubidoux II | Nurse Practitioner | 201 18th Ave, Lewiston, ID 83501-2768 | 2020-09-28 |
1275199663 | Jason T Elliott | Nurse Practitioner | 12094 N Barn Owl Way, Boise, ID 83714-1363 | 2019-05-12 |
1699055491 | Nicole Dawn Bartlett | Nurse Practitioner | 243 Cheney Dr W Ste 200, Twin Falls, ID 83301-4278 | 2011-08-24 |
1639364482 | Saint Alphonsus Specialty Services Inc | Nurse Practitioner | 660 E Boise Ave, Boise, ID 83706-5118 | 2007-09-13 |
1780879536 | Saint Alphonsus Specialty Services Inc | Nurse Practitioner | 2809 Cleveland Blvd, Caldwell, ID 83605-4443 | 2007-09-13 |
1962522409 | Wendy Swope | Nurse Practitioner | 3388 Highway 26, Irwin, ID 83428 | 2007-03-29 |
1336193598 | Angela K. Hughes | Nurse Practitioner | 6933 W Emerald St, Boise, ID 83704-8616 | 2006-05-20 |
1174156962 | Rachel Lynne Davis | Nurse Practitioner | 190 E Bannock St, Boise, ID 83712-6241 | 2020-02-20 |
1205489978 | Kimereng Kipchumba Kipsuge | Nurse Practitioner | 1717 Arlington Ave, Caldwell, ID 83605-4802 | 2019-07-22 |
1154823433 | Christopher R Counsil | Nurse Practitioner | 190 E Bannock St, Boise, ID 83712-6241 | 2018-03-02 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on TRACY K MATALON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.