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Kim Mattingly, MSL,TSAC-F
Military Health Care Provider in Sanford, North Carolina
NPI 1558951657

Kim Mattingly is a Military Health Care Provider based in Sanford, NC. Kim Mattingly practices in Sanford, NC and has the professional credentials of MSL,TSAC-F. The NPI Number for Kim Mattingly is 1558951657 and holds a License No. 001000656 (North Carolina).

The current practice location address for Kim Mattingly is 985 Buffalo Lake Rd, Sanford, NC and can be reached out via phone at 910-578-4180.

Location: 985 Buffalo Lake Rd, Sanford, NC, 27332-2351
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558951657
Provider Name
Kim Mattingly
Credential
MSL,TSAC-F
Provider Entity Type
Individual
Gender
Female
Address
985 Buffalo Lake Rd, Sanford, NC, 27332-2351
Phone Number
910-578-4180
Fax Number
Provider Enumeration Date
01/22/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001000656 01 NC NSCA
institution
Provider Business Practice Location Address Details
Address
985 Buffalo Lake Rd
City
Sanford
State
North Carolina
Zip
27332-2351
Phone Number
910-578-4180
Fax Number
person
Provider Business Mailing Address Details
Address
985 Buffalo Lake Rd
City
Sanford
State
North Carolina
Zip
27332-2351
Phone Number
910-578-4180
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
001000656 (North Carolina)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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