Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANDREA M MATTISON, PAC
ActiveMedical Physician Assistant · KENOSHA, WI
Registration Details
- NPI Number
- 1902852072
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 26, 2006 (19.904906801953 yrs)
- Last Updated
- Sep 13, 2016
- License
-
1391 (WI)
Practice Information
- Address
-
3400 MARKET LNKENOSHA, WI, 531443430Browse WI providers · Browse ZIP 53144
- Phone
- 2625514600
- Fax
- 2625514630
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in KENOSHA, WI
| Name | Credential | NPI |
|---|---|---|
| HEATHER M BARRETT | PA | 1629080247 |
| RYAN OTTO | — | 1457004517 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.