Provider Demographics
NPI:1972113363
Name:MATHEWS, RINI SUSAN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:RINI
Middle Name:SUSAN
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 S EASTERN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2875
Mailing Address - Country:US
Mailing Address - Phone:702-483-3554
Mailing Address - Fax:725-267-1020
Practice Address - Street 1:8420 S EASTERN AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2875
Practice Address - Country:US
Practice Address - Phone:702-483-3554
Practice Address - Fax:725-267-1020
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV832833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily