Heather Elizabeth Difederico, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

643867 Issued in NY

Practice address

101 Carter Rd
Geneva, NY 14456-1053

Phone

(315) 781-0402

Fax

(315) 828-1790

NPI assigned

May 2, 2019

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

Other names 1

• Heather Elizabeth McKane Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1235794553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CARTER RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561092",
            "telephone_number": "315-781-0402",
            "fax_number": "315-828-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CARTER RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561053",
            "telephone_number": "315-781-0402",
            "fax_number": "315-828-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFEDERICO",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "643867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MCKANE",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• School Registered Nurse in Geneva, NY
• Providers in Geneva, NY by specialty
• School Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.