MIKKLENA M MATTHEWS (NPI# 1821170051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821170051 |
| Entity Type | Individual |
| Full Name | MIKKLENA M MATTHEWS |
| Credential | FNP |
| Practice Address |
1601 W. St. Mary's Rd Tucson AZ 85745-2623 |
| Mailing Address |
630 N. Alvernon Way Tucson AZ 85711-0000 |
| Practice Telephone | 5208723000 |
| Mailing Telephone | 5206478850 |
| Mailing Fax Number | 5206478851 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2009-04-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | AP3293 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 59073 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | MIDLANDS CHOICE FOR IOWA | 254537 | 01 |
| NE | MIDLANDS CHOICE FOR NERBASKA | 254537 | 01 |
| NE | BCBSNE | 39139 | 01 |
| IA | 100251147-00 | 05 | |
| IA | BCBSNE FOR IOWA | 39258 | 01 |
| Street Address |
1601 W. ST. MARY'S RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85745-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598737074 | Marcel P Garr | Physician Assistant | 1601 W. St. Mary's Rd, Tucson, AZ 85745-2623 | 2006-02-07 |
| 1356599013 | Chad R Stadheim | Emergency Medicine | 1601 W. St. Mary's Rd, Department of Emergency Medicine, Tucson, AZ 85745-2623 | 2008-09-05 |
| 1851552368 | Lisa Anne Tarris | Emergency Medicine | 1601 W. St. Mary's Rd, Room 1107g West Wing, Tucson, AZ 85745-2623 | 2008-06-18 |
| 1982888962 | Alicia F Aguilar | Nurse Practitioner | 1601 W. St. Mary's Rd, Tucson, AZ 85745-2623 | 2007-12-26 |
| 1164602215 | Lisa A Briggs | Nurse Practitioner | 1601 W. St. Mary's Rd, Tucson, AZ 85745-2623 | 2007-11-06 |
| 1346442191 | David Roy Pickavance | Physical Therapist | 1601 W. St. Mary's Rd, St. Mary's Hospital, Tucson, AZ 85745 | 2007-06-04 |
| 1164631420 | Adrienne Alice Yarnish | Emergency Medicine | 1601 W. St. Mary's Rd, Tucson, AZ 85745-2623 | 2007-05-22 |
| 1679615488 | Sonia Elizabeth Evans | Counselor | 1601 W. St. Mary's Rd, Tucson, AZ 85745 | 2007-02-12 |
| 1023182052 | Nelson Ricardo Rosario-leon | Psychiatry & Neurology | 1601 W. St. Mary's Rd, Unit 2 North St. Mary's Hospital, Tucson, AZ 85795 | 2006-11-20 |
| 1417032079 | Richard A Wagner | Emergency Medicine | 1601 W. St. Mary's Rd, Tucson, AZ 85745-2623 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629540679 | El Rio Santa Cruz Neighborhood Health Center Inc | Pharmacy | 839 W Congress, Tucson, AZ 85745 | 2018-12-31 |
| 1194230672 | Pascua Yaqui Tribe | Community/Behavioral Health | 1701 W. St. Mary's Road, Suite 120, Tucson, AZ 85745 | 2017-12-06 |
| 1891207106 | Intermountain Health Center, Inc. | Community/Behavioral Health | 1100 W. Fresno Street, Tucson, AZ 85745 | 2017-10-26 |
| 1497270664 | Skin Concierge, LLC. | Dermatology | 1310 W. St. Mary's Road, 2nd Floor, Suite A, Tucson, AZ 85745 | 2017-08-09 |
| 1801334941 | Katie Flores | Physical Therapist | 1604 W St Mary's Rd, Tucson, AZ 85745 | 2017-02-09 |
| 1558717348 | Jeongfill Yun | Student in an Organized Health Care Education/Training Program | 8290 W Congress St., Tucson, AZ 85745 | 2016-05-11 |
| 1417317082 | Nebsource LLC | Durable Medical Equipment & Medical Supplies | 4890 W Camino De La Amapola, Tucson, AZ 85745 | 2016-02-25 |
| 1548661358 | Melinda Godoy | Pharmacist | 879 W Congress, Tucson, AZ 85745 | 2014-09-11 |
| 1811333925 | Asdb | Clinic/Center | 1200 West Speedway, Tucson, AZ 85745 | 2013-05-15 |
| 1669722385 | David L. Lewis | Counselor | 1779 W. St. Mary's Rd, Tucson, AZ 85745 | 2012-09-11 |
| Find all providers in zip 85745 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966640 | Stephanie Alonso | Physician Assistant | 7725 N Sun Flair Dr, Tucson, AZ 85741-1582 | 2020-09-14 |
| 1902416084 | Nooria Sufi | Physician Assistant | 3849 E Calle De Soto, Tucson, AZ 85716-5125 | 2020-08-04 |
| 1578189650 | Emily Alaine Maru | Physician Assistant | 9641 E Waters Edge Pl, Tucson, AZ 85749-7901 | 2020-06-24 |
| 1144863481 | Daniel E Valdez | Physician Assistant | 7360 S Frost Dr, Tucson, AZ 85747-5641 | 2019-10-18 |
| 1831663731 | Chenin Poels | Physician Assistant | 1652 E Saint Ferdinand Pl, Tucson, AZ 85713-5185 | 2019-01-14 |
| 1750864310 | Stephen Skiano | Physician Assistant | 3615 N Prince Village Pl Ste 121, Tucson, AZ 85719-2034 | 2018-09-10 |
| 1215415112 | Chelsea Marie Baker | Physician Assistant | 2495 N Desert Links Dr Apt 11, Tucson, AZ 85715-3727 | 2018-08-02 |
| 1891209268 | Samantha Martinez | Physician Assistant | 7089 N Thornydale Rd, Tucson, AZ 85741-2728 | 2017-11-21 |
| 1851819692 | Clayton Harrison Andrews | Physician Assistant | 1501 N Campbell Ave Rm 4325, Tucson, AZ 85724-0001 | 2017-08-31 |
| 1831613579 | Ashley Shaw | Physician Assistant | 5856 N Placita Esplendora, Tucson, AZ 85718 | 2017-08-02 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.