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General NPI Number Information
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NPI Number | 1639567761
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Entity Type | Individual
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Provider Name | CHRISTINA MATOSKI FNP
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Gender | Female
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 1101 GLENDALE BLVD STE 100
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City | VALPARAISO
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State | IN
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Zip | 46383-3789
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Country | US
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Telephone | 219-510-8888
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Fax | 833-941-2562
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Provider Business Mailing Address
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Address Line | 3777 FRONTAGE RD
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-7695
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Country | US
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Telephone | 219-877-3877
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Fax | 219-877-3860
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28175093A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71005289A
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License Number State | IN
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