Individual
HEATHER D MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
(541) 494-9355
Mailing address
3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
(541) 494-9355
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201241027RN
OR
363L00000X
Nurse Practitioner
Primary
10002945
OR
Other
Enumeration date
07/22/2021
Last updated
12/28/2022
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