MRS. MARY KATHLEEN MATZKO NURSE PRACTITIONER NPI 1417388141

NPI Information

NPI: 1417388141
Provider Name: MRS. MARY KATHLEEN MATZKO, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: PRISMA HEALTH MEDICAL GROUP-MIDLANDS

PECOS Registration: Yes

Address:
14 RICHLAND MEDICAL PARK DR STE 410
COLUMBIA, SC
ZIP 29203
Phone: (803) 434-8740
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MRS. Mary Kathleen Matzko, NURSE PRACTITIONER is an adult health nurse practitioner in Columbia, SC with 11 years of experience. MRS. Mary Kathleen Matzko, NURSE PRACTITIONER NPI is 1417388141. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14 RICHLAND MEDICAL PARK DR STE 410
COLUMBIA, SC
ZIP 29203-878
Phone: (803) 434-8740
Fax: (803) 434-8749

The NPI 1417388141 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 12/5/2013 and was last updated on 9/16/2021.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	18599	SOUTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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