Individual provider · Type 1 NPI

Jessica Marie Dziondziak

Nurse Practitioner · Fort Wayne, IN

NPI number 1104620970 Active

Practice location

2710 Lake Ave
Fort Wayne, IN 46805-5412

Call (260) 481-2700 Map

Fax (260) 969-8448

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	71018138A (IN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104620970

Jessica Marie Dziondziak's National Provider Identifier is 1104620970, issued on Apr 2, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Jun 30, 2026.