| Primrose Mental Health Pllc | |
|
1400 Madison Ave Ste 614 Mankato MN 56001-5488 | |
| (507) 613-3883 | |
| (360) 282-1236 |
| Full Name | Primrose Mental Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1400 Madison Ave Ste 614, Mankato, Minnesota |
| Authorized Official Name and Position | Paul Matson (PRESIDENT) |
| Authorized Official Contact | 3609415900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primrose Mental Health Pllc 120 Oak Marsh Dr Mankato MN 56001-8762 Ph: (360) 941-5900 | Primrose Mental Health Pllc 1400 Madison Ave Ste 614 Mankato MN 56001-5488 Ph: (507) 613-3883 |
| NPI Number | 1528648870 |
|---|---|
| Provider Enumeration Date | 04/12/2021 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/09/2024 |
| Medicare PECOS PAC ID | 2466842745 |
|---|---|
| Medicare Enrollment ID | O20211130001884 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528648870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Paul Lawrence Matson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235678954 PECOS PAC ID: 8729330337 Enrollment ID: I20181010000331 |
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