Provider Demographics
NPI:1306619937
Name:MATTHEWS, ADRIENNE L
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:L
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LACLEDE DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2901
Mailing Address - Country:US
Mailing Address - Phone:973-905-2193
Mailing Address - Fax:
Practice Address - Street 1:5 LACLEDE DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2901
Practice Address - Country:US
Practice Address - Phone:973-905-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider