Provider Demographics
NPI:1427949825
Name:BIRNIE, MATTHEW
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BIRNIE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 BYERS DR
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-1017
Mailing Address - Country:US
Mailing Address - Phone:480-334-5897
Mailing Address - Fax:480-334-5897
Practice Address - Street 1:1109 BYERS DR
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-1017
Practice Address - Country:US
Practice Address - Phone:480-334-5897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE402908163747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant