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NPI 1376008557

IndividualActive

Amanda Mata, RN

NPI 1376008557 · Registered Nurse · Southgate, MI

Provider details

NPI number: 1376008557
Entity type: Individual
Primary specialty: Registered NurseNursing Service Providers
Credential: RN
Sex: Female
Sole proprietor: No
License: 4704319275 (MI)

Practice location

13305 Reeck Ct

Southgate, MI 48195-3197

Phone: (734) 225-2090

More MI providers

Mailing address

6549 Town Center Dr Ste a

Clarkston, MI 48346-4824

Registry dates

Enumerated: 2019-02-01
Last updated: 2019-02-01

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Amanda Mata, RN — NPI 1376008557, Southgate, MI | NPI Central