Mikklena M Matthews, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1146 Issued in WY

Practice address

1898 Fort Rd
Sheridan, WY 82801-8320

Phone

(307) 672-3473

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Room Associates

  • Physician Assistant
  • Tucson, AZ
  • NPI 1457576068
  NPD (past)
• Emergency Room Associates Limited

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1770586869
  NPD (past)
• New Century Physicians of Iowa PC

  • Emergency Medicine Physician
  • Council Bluffs, IA
  • NPI 1548269301
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1821170051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 FORT RD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828018320",
            "telephone_number": "307-672-3473",
            "fax_number": "307-672-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 FORT RD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828018320",
            "telephone_number": "307-672-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "MIKKLENA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "AP3293",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "1146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNE FOR IOWA",
            "identifier": "39258",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251147-00",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE FOR NERBASKA",
            "identifier": "254537",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNE",
            "identifier": "39139",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE FOR IOWA",
            "identifier": "254537",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsi Marie Martinez, MS, CCC-SLP
• Martini Anesthesia Services LLC
• Elizabeth M Martini, MA, CRC, LPC
• Kassahn Mathson, LCSW
• Christina Maria Mathyssek
• Matthew Matzen
• Bridgette Maxey
• Nicole Christine Maxey, R.N.
• Thomas Otto Mayer, MD
• MBS LLC

• Family Nurse Practitioner in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Family Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.