Provider Demographics
NPI:1790663953
Name:MATTHEWS, DOREEN
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 SUNNYHILL DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-4860
Mailing Address - Country:US
Mailing Address - Phone:404-931-7445
Mailing Address - Fax:
Practice Address - Street 1:476 SUNNYHILL DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-4860
Practice Address - Country:US
Practice Address - Phone:404-931-7445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider