JENNA MARIE WATERMAN PA-C
NPI 1780156299
Physician Assistant in Fort Wayne, IN

Q: What is Jenna Waterman's NPI number?

The NPI number for Jenna Waterman is 1780156299. It was assigned to this individual provider in the NPPES registry on December 21, 2018.

Q: What is Jenna Waterman's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jenna Waterman was last updated on September 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 21, 2018

7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804(383) 026-0458 Get Directions Write a Review

NPPES record last updated: September 21, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 21, 2020, Dec 21, 2018 (2 updates tracked since 2018).

On this page

About Jenna Marie Waterman Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNA MARIE WATERMAN PA-C (NPI 1780156299) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10002636A) and active in the NPI registry since December 2018.

NPPES Registry Identity

NPI1780156299

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJENNA MARIE WATERMANCredential: PA-C

Location Address7333 W JEFFERSON BLVDFort Wayne, IN 46804-6202

Mailing Address7333 W Jefferson BlvdFort Wayne, IN 46804-6202 · (383) 026-0458

Phone(383) 026-0458

Sole ProprietorNo

Enumeration DateDecember 21, 2018

Last NPPES UpdateSeptember 21, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2020

✔ NPI 1780156299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IN · 10002636A

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

7333 W JEFFERSON BLVD, Fort Wayne, IN 46804

Open in Google Maps ↗

Other Identifiers 1

Medicaid300021873IN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROLAND STUCKEY MD

Family Medicine