Provider Demographics
NPI:1811282114
Name:MALFITANO, JOSEPHINE MARIE (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:MARIE
Last Name:MALFITANO
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FAIRWAY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-8118
Mailing Address - Country:US
Mailing Address - Phone:910-382-6955
Mailing Address - Fax:
Practice Address - Street 1:115 FAIRWAY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-8118
Practice Address - Country:US
Practice Address - Phone:910-382-6955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336752-1363LF0000X
NC128237 - 5005139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily