Individual provider · Type 1 NPI

Stephanie Nicole Matacia, NP

Gerontology Nurse Practitioner · Columbus, OH

NPI number 1649942715 Active

Practice location

1210 Gemini Pl Ste 300
Columbus, OH 43240-6112

Mailing address

PO Box 734439
Chicago, IL 60673-4439

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600XAPRN.CNP.0027442 (OH)
Interventional Pain Medicine Physician 208VP0014XAPRN.CNP.0027442 (OH)
Nurse Practitioner 363L00000XAPRN.CNP.0027442 (OH)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1649942715

Stephanie Nicole Matacia, NP's National Provider Identifier is 1649942715, issued on Sep 28, 2021. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Columbus, OH. The record was last updated on Jul 20, 2026.