Provider Demographics
NPI:1619216991
Name:DEFRANGESCO, JEANNE RAGAN (CRNP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:RAGAN
Last Name:DEFRANGESCO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 BRECKENRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-3061
Mailing Address - Country:US
Mailing Address - Phone:215-393-9589
Mailing Address - Fax:
Practice Address - Street 1:1505 BRECKENRIDGE PL
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-3061
Practice Address - Country:US
Practice Address - Phone:215-393-9589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011743363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health