TRACY K MATALON


Address: 3340 E Goldstone Way, Meridian, ID 83642-1026
Phone: 2083675189

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 3340 E GOLDSTONE WAY
City MERIDIAN
State ID
Zip Code 83642-1026

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City MERIDIAN
Zip Code 83642

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Dataset Information

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.

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