Provider Demographics
NPI:1588097216
Name:MATUS, MONICA H (CRNA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:H
Last Name:MATUS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:J
Other - Last Name:HABECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:701 E MARSHALL ST # 141
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4412
Mailing Address - Country:US
Mailing Address - Phone:610-431-5472
Mailing Address - Fax:
Practice Address - Street 1:701 E MARSHALL ST # 141
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4412
Practice Address - Country:US
Practice Address - Phone:610-431-5472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN611854363L00000X
VA0001217702163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner