IndividualActive
Kim Mattson
NPI 1053473587 · Emergency Registered Nurse · Phoenix, AZ
Provider details
- NPI number
- 1053473587
- Entity type
- Individual
- Primary specialty
- Emergency Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- RN00097025 (WA)
Specialties & taxonomies
Nursing Service Providers
Practice location
4212 N 16th St
Phoenix, AZ 85016-5319
Phone: (602) 263-1511
Fax: (602) 263-1619
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 31001
Pasadena, CA 91110-0698
Registry dates
- Enumerated
- 2006-12-14
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.