Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Diane Mata

Individual provider Family Nurse Practitioner · NPI 1922747294

Jennifer Diane Mata is a Family Nurse Practitioner in Fort Wayne, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone: (260) 426-5431
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71014672A (IN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 71014672A (IN)

Record details

NPI number1922747294
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 3, 2022
Last updated in NPPESMay 17, 2024
Certification dateMay 17, 2024

Other providers in Fort Wayne