Provider Demographics
NPI:1366899486
Name:MATRE, ELIZABETH CARRIE (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CARRIE
Last Name:MATRE
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 MEDOMA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-2181
Mailing Address - Country:US
Mailing Address - Phone:614-354-2449
Mailing Address - Fax:
Practice Address - Street 1:1885 WEST HENDERSON RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-2501
Practice Address - Country:US
Practice Address - Phone:614-354-2449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18940-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily