Individual provider Active NPI

Jennifer Difatta, CRNP

  • Adult Health Nurse Practitioner
  • Towson, MD
National Provider Identifier
1083539563
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R172197 Issued in MD
Practice address
515 Fairmount Ave Ste 330
Towson, MD 21286-5466
Phone
(410) 494-1313
Fax
(410) 584-2250
NPI assigned
Aug 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R172197 MD Primary

Addresses

Primary practice location

515 Fairmount Ave Ste 330
Towson, MD 21286-5466

Mailing address

515 Fairmount Ave Ste 400
Towson, MD 21286-8518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1786492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1083539563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE STE 400",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE STE 330",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-494-1313",
            "fax_number": "410-584-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFATTA",
        "first_name": "JENNIFER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R172197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.