JENNIFER L VAN MATRE-WATTLES NP NPI 1821730193

NPI Information

NPI: 1821730193
Provider Name: JENNIFER L VAN MATRE-WATTLES, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
W231N1440 CORPORATE CT
WAUKESHA, WI
ZIP 53186
Phone: (262) 896-6000
Get Directions

Jennifer L Van Matre-wattles, NP is a psychiatric/mental health nurse practitioner in Waukesha, WI with 3 years of experience. Jennifer L Van Matre-wattles, NP NPI is 1821730193. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

W231N1440 CORPORATE CT
WAUKESHA, WI
ZIP 53186-303
Phone: (262) 896-6000

The NPI 1821730193 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/8/2022 and was last updated on 10/26/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		11873	WISCONSIN	No
2	363L00000X	Nurse Practitioner		163519	WISCONSIN	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	11873	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100199781	MEDICAID	WISCONSIN
2	100199803	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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