Jennifer Mata

NPI 1922747294 · on the registry since 2022 · sole proprietor

Practice

Address: 2121 Lake Ave
Fort Wayne, IN 46805
Phone: (260) 426-5431
Organisation at this address: Nihcs
Marion Vamc
Marion Vamc
Va Hospital
Va Northern Indiana Hcs
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 354

Registry record

Primary taxonomy: Nurse Practitioner
363L00000X
Also registered as: Family Nurse Practitioner
Licence states on file: IN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-05-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana