Individual
JENNIFER DIANE MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71014672A
IN
363LF0000X
Family Nurse Practitioner
71014672A
IN
Other
Enumeration date
06/03/2022
Last updated
05/17/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us