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General NPI Number Information
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NPI Number | 1932156551
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Entity Type | Individual
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Provider Name | JENNIFER T DI CECCO CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 39173 WHISPER WEST COURT
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City | SOLDOTNA
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State | AK
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Zip | 99669
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Country | US
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Telephone | 205-396-6992
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Fax | 907-416-3345
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Provider Business Mailing Address
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Address Line | 39173 WHISPER WEST COURT
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City | SOLDOTNA
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State | AK
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Zip | 99669
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Country | US
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Telephone | 205-396-6992
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Fax | 907-416-3345
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704431628
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60814170
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 200646
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License Number State | AK
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