Provider Demographics
NPI:1487286688
Name:MATHEWSON, ELIZABETH L (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:MATHEWSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-8400
Mailing Address - Country:US
Mailing Address - Phone:179-241-4455
Mailing Address - Fax:
Practice Address - Street 1:2900 WATKINS RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-8604
Practice Address - Country:US
Practice Address - Phone:269-245-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704249800NSA2002S363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily