Individual
MRS. JENNIFER JEAN MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
718 N MACOMB ST, MONROE, MI 48162-7815
(734) 240-5860
Mailing address
770 MILDRED AVE, TEMPERANCE, MI 48182-9203
(734) 244-2353
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
4704305266
MI
363L00000X
Nurse Practitioner
Primary
4704305266
MI
Other
Enumeration date
01/06/2020
Last updated
02/19/2026
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