Provider Demographics
NPI:1083814495
Name:DEFILIPPO, JESSICA HELEN (CPM, LM)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:HELEN
Last Name:DEFILIPPO
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24583 TOWN HALL RD
Mailing Address - Street 2:
Mailing Address - City:HERTEL
Mailing Address - State:WI
Mailing Address - Zip Code:54845-9702
Mailing Address - Country:US
Mailing Address - Phone:715-468-4190
Mailing Address - Fax:715-468-4193
Practice Address - Street 1:24583 TOWN HALL RD
Practice Address - Street 2:
Practice Address - City:HERTEL
Practice Address - State:WI
Practice Address - Zip Code:54845-9702
Practice Address - Country:US
Practice Address - Phone:715-468-4190
Practice Address - Fax:715-468-4193
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25-049176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife