| Doctor Name: | HOPE M MATHERN |
| NPI Number: | 1073881918 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R206415-4 |
| Business Practice Address: | 1027 Washington Ave Detroit Lakes, MN - 565013409 |
| Business Phone Number: | 2188475611 |
| Business Fax Number: | 2188470881 |
| Mailing Address: | 1027 Washington Ave, DETROIT LAKES |
| State: | MN |
| Postal Code: | 565013409 |
| Phone Number: | 2188475611 |
| Fax Number: | 2188470881 |
| NPI Enumeration Date: | 12/07/2011 |
| NPI Last Update Date: | 06/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R206415-4 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |