Provider Demographics
NPI:1962298869
Name:MATUS, JEAN
Entity type:Individual
Prefix:MR
First Name:JEAN
Middle Name:
Last Name:MATUS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 PARK GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-3628
Mailing Address - Country:US
Mailing Address - Phone:406-403-9728
Mailing Address - Fax:
Practice Address - Street 1:1208 PARK GARDEN RD
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-3628
Practice Address - Country:US
Practice Address - Phone:406-403-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNURRNLIC102657163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine