| NPI | 1063184372 |
|---|---|
| Former Name | ALEC RAYE MATTESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1055515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1055515) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2025-11-17 |