Provider Demographics
NPI:1659736668
Name:MATTINA, JOCELYN (MSN, AGNP)
Entity Type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:
Last Name:MATTINA
Suffix:
Gender:F
Credentials:MSN, AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7085 GUN CLUB RD
Mailing Address - Street 2:
Mailing Address - City:NEW TRIPOLI
Mailing Address - State:PA
Mailing Address - Zip Code:18066-4302
Mailing Address - Country:US
Mailing Address - Phone:610-509-1829
Mailing Address - Fax:
Practice Address - Street 1:2401 PARK DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9303
Practice Address - Country:US
Practice Address - Phone:610-509-1829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008240363LP2300X
PASP017765363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care