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

Jessica Marie Dziondziak

Individual provider Nurse Practitioner · NPI 1104620970

Jessica Marie Dziondziak is a Nurse Practitioner in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2025.

Licensed in
IN
In the registry since
2025

Practice location Address checks out

2710 Lake Ave
Fort Wayne, IN 46805-5412
Phone: (260) 481-2700
Fax: (260) 969-8448
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71018138A (IN)

Record details

NPI number1104620970
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 2, 2025
Last updated in NPPESJune 30, 2026
Certification dateJune 30, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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