Basic Information
| Provider Information | |||||||||
| NPI: | 1184388167 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATUS | ||||||||
| FirstName: | CARLA | ||||||||
| MiddleName: | AMAT | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 349 JUNIPER ST | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800272647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7209350351 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 ERIE PKWY STE 101 | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805164071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034155810 | ||||||||
| FaxNumber: | 3034155820 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2021 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN.0997026-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.