JENNIFER DIANE MATA NPI 1922747294

NPI Information

  • NPI: 1922747294
  • Provider Name: JENNIFER DIANE MATA
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • Address: 2121 LAKE AVE
    FORT WAYNE, IN
    ZIP 46805
  • Phone: (260) 426-5431

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NPI Details

Jennifer Diane Mata is a nurse practitioner in Fort Wayne, IN. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Jennifer Diane Mata NPI is 1922747294. 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:

2121 LAKE AVE
FORT WAYNE, IN
ZIP 46805-100
Phone: (260) 426-5431

The enumeration date for this NPI number is 6/3/2022 and was last updated on 5/17/2024.

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
1363LF0000XNurse PractitionerFamily71014672AINDIANANo
2363L00000XNurse Practitioner71014672AINDIANAYes

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: 11/21/2025

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