Provider Demographics
NPI:1568254175
Name:POMALES, MATTHEW (APRN-CNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:POMALES
Suffix:
Gender:M
Credentials:APRN-CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 MARLOWE AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-3043
Mailing Address - Country:US
Mailing Address - Phone:727-459-0092
Mailing Address - Fax:
Practice Address - Street 1:1537 MARLOWE AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-3043
Practice Address - Country:US
Practice Address - Phone:727-459-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034920363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0034920OtherOHIO BOARD OF NURSING
OHRN.470718OtherOHIO BOARD OF NURSING