Mircia Matos, RN

Individual provider Active NPI Registered Nurse · N Little Rock, AR

NPI 1962075622 · NPPES record last updated Jul 21, 2021

Key facts

NPI
1962075622
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R092350 (AR)
Practice address
4405 E 46TH St Apt 20
N Little Rock, AR 72117-1966
Phone
(501) 259-3271
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R092350ARMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R092350 AR Yes

Addresses

Primary practice location

4405 E 46TH St Apt 20
N Little Rock, AR 72117-1966

Mailing address

4405 E 46TH St Apt 20
N Little Rock, AR 72117-1966
Phone (501) 259-3271

Other providers in N Little Rock, AR

All providers in N Little Rock, AR · Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.