Jacqueline Lee Destro, C.R.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

UP001881D Issued in PA

Practice address

221 Penn Ave
Wilkinsburg, PA 15221-2118

Phone

(412) 865-6589

NPI assigned

Jan 30, 2007

Last updated

Jul 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jdestro@direct.excelahealth.org

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1164568465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WOODSIDE RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152213638",
            "telephone_number": "412-247-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PENN AVE",
            "city": "WILKINSBURG",
            "state": "PA",
            "postal_code": "152212118",
            "telephone_number": "412-865-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTRO",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "UP001881D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Chukwuedo, NCC, LPC
• William T Conklin, MD
• Elwin M Cotman, OD
• Sheila Marie Craig, RN
• Jaclyn Ava Deem, M.S., L.P.C.
• Abigail Jean Dudzic, LPC
• Krysta Enchill
• Stacy Fincher
• Kevin Flaherty, PHARMD
• Rikell Shawntae Ford, LCSW

• Pediatric Nurse Practitioner in Wilkinsburg, PA
• Providers in Wilkinsburg, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.