Individual provider · Type 1 NPI
Jennifer Diane Mata
Nurse Practitioner · Fort Wayne, IN
Practice location
2121 Lake Ave
Fort Wayne, IN 46805-5100
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71014672A (IN) |
| Nurse Practitioner Primary | 363L00000X | 71014672A (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 1922747294
Jennifer Diane Mata's National Provider Identifier is 1922747294, issued on Jun 3, 2022. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on May 17, 2024.