Provider Demographics
NPI:1366657157
Name:DIFEO, NATALIE (CRNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:DIFEO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MCCLEARY
Other - Last Name:DIFEO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:12 ENDSLOW LN
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-2600
Mailing Address - Country:US
Mailing Address - Phone:215-258-0129
Mailing Address - Fax:
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:5 WOOD-PULMONARY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-4106
Practice Address - Fax:215-590-3500
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008996363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics