Individual
AMBER MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 988-6958
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(800) 516-5315
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN133561
LA
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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