John Michael Blanco Mata, NP
Nurse Practitioner · Prescott, AZ
Practice location
3250 Gateway Blvd Ste 112Prescott, AZ 86303-6856
- Phone
- (708) 248-0049
NPI record
- NPI
- 1639871247
- Entity type
- Individual (Type 1)
- Enumeration date
- March 20, 2023
- Last updated
- January 31, 2024
- Certified
- January 31, 2024
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X |
267971 | AZ |
| Acute Care Nurse Practitioner | 363LA2100X |
267971 | AZ |
| Adult Health Nurse Practitioner | 363LA2200X |
267971 | AZ |
| Critical Care Medicine Nurse Practitioner | 363LC0200X |
267971 | AZ |
| Gerontology Nurse Practitioner | 363LG0600X |
267971 | AZ |
Mailing address
PO Box 522Humboldt, AZ 86329-0522
- Phone
- (708) 248-0049
About John Michael Mata
John Michael Blanco Mata, NP is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 3250 Gateway Blvd Ste 112, Prescott, AZ 86303-6856. The NPI number 1639871247 was assigned on March 20, 2023 and the record was last updated on January 31, 2024.
John Michael Mata lists 5 licenses in the registry: #267971 (AZ) for Nurse Practitioner; #267971 (AZ) for Acute Care Nurse Practitioner; #267971 (AZ) for Adult Health Nurse Practitioner; #267971 (AZ) for Critical Care Medicine Nurse Practitioner; #267971 (AZ) for Gerontology Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of John Michael Blanco Mata, NP?
The NPI number is 1639871247.
What is the phone number of John Michael Mata?
The phone number listed for the practice location is (708) 248-0049.
Where is John Michael Mata located?
3250 Gateway Blvd Ste 112, Prescott, AZ 86303-6856.
What is the taxonomy code for John Michael Mata?
The primary taxonomy code is 363L00000X – Nurse Practitioner; 4 more listed above.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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