MR. MICHAEL TODD MATHISEN APRN PMHNP-BC NPI 1114487881

NPI Information

MR. Michael Todd Mathisen, APRN, PMHNP-BC is a psychiatric/mental health nurse practitioner in Las Vegas, NV with 6 years of experience. MR. Michael Todd Mathisen, APRN, PMHNP-BC NPI is 1114487881. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4270 S DECATUR BLVD STE B6
LAS VEGAS, NV
ZIP 89103-802
Phone: (702) 485-2100
Fax: (702) 902-2466

The NPI 1114487881 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2019 and was last updated on 3/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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