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NPI Code Detail

MEDICARE: KATHERINE MATTY CNM

MEDICARE: KATHERINE MATTY CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife9437033FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578015095
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MATTY CNM
Provider Business Mailing Address
First Line : 15255 MAX LEGGETT PKWY STE 4400
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-7273
Country : US
Telephone Number : 904-383-1000
Fax Number :
Provider Business Practice Location Address
First Line : 15255 MAX LEGGETT PKWY STE 4400
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-7273
Country : US
Telephone Number : 904-383-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2016
Last Update Date : 03/04/2026

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Directions to “ KATHERINE MATTY CNM” Practice Location

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