ANDREA M MATTISON


Address: 3400 Market Ln, Kenosha, WI 53144-3430
Phone: 2625514600

ANDREA M MATTISON (NPI# 1902852072) 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) 1902852072
Entity Type Individual
Full Name ANDREA M MATTISON
Credential PAC
Practice Address 3400 Market Ln
Kenosha
WI 53144-3430
Practice Telephone 2625514600
Practice Fax Number 2625514630
Mailing Telephone 2625514600
Mailing Fax Number 2625514630
Enumeration Date 2006-05-26
Last Update Date 2016-09-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
1391 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 41928000 05

Other Providers ANDREA MATTISON

NPI Name Taxonomy Address Enumeration
1497205108 Andrea Mary Mattison Physical Therapist 2399 Ariel St #a, Saint Paul, MN 55108-2202 2016-10-05

Office Location

Street Address 3400 MARKET LN
City KENOSHA
State WI
Zip Code 53144-3430

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154377091 Keven R Mottinger Physician Assistant 3400 Market Ln, Kenosha, WI 53144-3430 2006-05-25
1083261226 Amanda Quinonez Nurse Practitioner 3400 Market Ln, Kenosha, WI 53144-3430 2019-08-22
1629534813 Heather Nicole Thomas Registered Nurse 3400 Market Ln, Kenosha, WI 53144-3430 2019-02-13
1922573625 Tarren Prange Nurse Practitioner 3400 Market Ln, Kenosha, WI 53144-3430 2018-10-09
1891260543 Stephanie M Brown Nurse Practitioner 3400 Market Ln, Kenosha, WI 53144-3430 2018-10-09
1790297331 Juli Marie Degrave Nurse Practitioner 3400 Market Ln, Kenosha, WI 53144-3430 2017-11-03
1750800884 Christos Reppas Physician Assistant 3400 Market Ln, Kenosha, WI 53144-3430 2017-09-09
1417497710 Shelley Flasch Nurse Practitioner 3400 Market Ln, Kenosha, WI 53144-3430 2017-03-06
1194193813 Sandra Homan Nurse Practitioner 3400 Market Ln, Kenosha, WI 53144-3430 2015-09-11
1326452921 Rebekah Costello Family Medicine 3400 Market Ln, Kenosha, WI 53144-3430 2014-06-12
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902410202 Dpt Holdings LLC Occupational Therapist 3825 39th Ave #110, Kenosha, WI 53144 2020-09-03
1225641392 Eunice Boatin Social Worker Kenosha Human Development Services, 3536 52nd Street, Kenosha, WI 53144 2020-08-28
1881250256 Shoptikal LLC Eyewear Supplier (Equipment, not the service) 3621 Market Lane, Kenosha, WI 53144 2019-05-11
1124540067 Kaitlyn King Speech-Language Pathologist 5219 88th Ave., Kenosha, WI 53144 2017-07-12
1174992721 Claire Ann Adams Acupuncturist 5416 52nd Street, Kenosha, WI 53144 2015-09-24
1285017087 Jessica Lynn Gillengerten Acupuncturist 4235 Green Bay Rd., Suite #10, Kenosha, WI 53144 2015-06-30
1750704656 Amanda Kay Kreuzer Occupational Therapy Assistant 3109 30th Ave, Kenosha, WI 53144 2014-01-28
1841626785 B7 Pharmacy Inc Pharmacy 3825 39th Ave Ste 100, Kenosha, WI 53144 2013-09-24
1124326764 Wisconsin Cvs Pharmacy LLC Durable Medical Equipment & Medical Supplies 3710 57th Ave, Kenosha, WI 53144 2011-03-07
1982931291 Roman Bilak General Practice 4126 - 7th Street, Kemosha, WI 53144 2009-11-06
Find all providers in zip 53144

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750800884 Christos Reppas Physician Assistant 3400 Market Ln, Kenosha, WI 53144-3430 2017-09-09
1053520544 Amber D Devine Physician Assistant 7401 104th Ave, Suite 110, Kenosha, WI 53142-7845 2007-05-21
1629080247 Heather M Barrett Physician Assistant 6308 8th Ave, Kenosha, WI 53143-5031 2006-08-12
1568496990 Jerrilyn Johnson Physician Assistant 8501 75th St, Suite J, Kenosha, WI 53142-7602 2006-07-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1093348542 Christopher Sean Lanctin Physician Assistant 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 2020-02-12
1750936068 Javier Eugenio Font Physician Assistant 813 N Clover Ln, Cottage Grove, WI 53527-9433 2019-08-04
1962056432 Lyndsey Marie Bratberg Physician Assistant F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 2019-08-01
1588225544 Hannah Elizabeth Krum Physician Assistant S80w17784 Brennan Dr, Muskego, WI 53150-8828 2019-06-21
1255825162 Katelyn Marie Frankwick Physician Assistant 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 2018-06-15
1831644228 Megan E Nelson Physician Assistant 221 E Mills Dr, Lake Mills, WI 53551-1910 2016-08-16
1356717904 Amy Hermus Physician Assistant 451 Butternut Dr, Oregon, WI 53575-1349 2015-08-18
1497168066 Alexander J Hill Physician Assistant 1111 North Road, Mauston, WI 53948-0700 2014-06-11
1487083242 Andrew John Miller Physician Assistant 1521 Lakeview Ave, Wausau, WI 54401-6168 2013-11-02
1386944502 Bethany Rose Yard Physician Assistant 18601 Lincoln Street, Whitehall, WI 54773 2010-10-22
Find all providers with the same taxonomy

Competitor

Search similar providers

City KENOSHA
Zip Code 53144

Improve Information

Please comment or provide details below to improve the information on ANDREA M MATTISON.

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.

Trending Searches