Individual provider · Type 1 NPI
Jacqueline Lee Destro, C.R.N.P.
Pediatric Nurse Practitioner · Wilkinsburg, PA
NPI number
1164568465
Active
Practice location
221 Penn Ave
Wilkinsburg, PA 15221-2118
Mailing address
240 Woodside Rd
Pittsburgh, PA 15221-3638
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | UP001881D (PA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1164568465
Jacqueline Lee Destro, C.R.N.P.'s National Provider Identifier is 1164568465, issued on Jan 30, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Wilkinsburg, PA. The record was last updated on Jul 15, 2013.