Individual
STEPHANIE NICOLE MATACIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1210 GEMINI PL STE 300, COLUMBUS, OH 43240-6112
(614) 383-6450
Mailing address
1210 GEMINI PL STE 300, COLUMBUS, OH 43240-6112
(614) 383-6450
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.0027442
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.0027442
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0463179
—
OH
Enumeration date
09/28/2021
Last updated
11/24/2025
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