Individual provider · Type 1 NPI

Elise K. Distefano, PA-C

Physician Assistant · Farmington, MO

NPI number 1104659713 Active

Practice location

1103 W Liberty St
Farmington, MO 63640-1921

Call (573) 760-8090 Map

Fax (573) 760-8260

Mailing address

PO Box 959354
St. Louis, MO 63195-9354

Other practice locations

  • 211 Saint Francis Dr, Cape Girardeau, MO 63703-5049 · (573) 331-5110

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X2024039608 (MO)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104659713

Elise K. Distefano, PA-C's National Provider Identifier is 1104659713, issued on Aug 21, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Farmington, MO. The record was last updated on Oct 6, 2026.