Provider Demographics
NPI:1689221731
Name:CIFONE, KATELYN MARY (APRN NP-C)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARY
Last Name:CIFONE
Suffix:
Gender:F
Credentials:APRN NP-C
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MARY
Other - Last Name:MACARUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 ROXBURY RD
Mailing Address - Street 2:
Mailing Address - City:PLANTSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06479-1458
Mailing Address - Country:US
Mailing Address - Phone:508-612-9963
Mailing Address - Fax:
Practice Address - Street 1:130 ROXBURY RD
Practice Address - Street 2:
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479-1458
Practice Address - Country:US
Practice Address - Phone:508-612-9963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily