Provider Demographics
NPI:1295955821
Name:MATUSZEWSKI, FRANCES MARGARET (APRN)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:MARGARET
Last Name:MATUSZEWSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:FRAN
Other - Middle Name:M
Other - Last Name:MATUSZEWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:100 S 1000 W
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4010
Mailing Address - Country:US
Mailing Address - Phone:435-843-3520
Mailing Address - Fax:435-843-3555
Practice Address - Street 1:85 W VINE ST
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-2034
Practice Address - Country:US
Practice Address - Phone:435-882-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT288667-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000062784Medicare PIN