Provider Demographics
NPI:1871368597
Name:DIFILLIPO, VANESSA CHRISTINE (RESISTED NURSE)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:CHRISTINE
Last Name:DIFILLIPO
Suffix:
Gender:F
Credentials:RESISTED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HERMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 TURNPIKE ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:781-646-0500
Practice Address - Fax:781-551-3396
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2300322163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult