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Individual
JESSICA DIFABIO
Active
Individual
JESSICA DIFABIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
6664
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004217099
—
CT
05
—
008039745
—
CT
05
—
008056033
—
CT
05
—
008056168
—
CT
01
—
008068420
SCHEFILITI MEDICAID #
CT
Enumeration date
09/29/2016
Last updated
01/24/2022
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