Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Lydia Difelice, PA-C

Individual provider Physician Assistant · NPI 1316753254

Jacqueline Lydia Difelice, PA-C is a Physician Assistant in Marietta, Georgia. Qualified in 2024, 2 years ago. Practices with Resurgens, LLC, a 182-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

61 Whitcher St NE Ste 1100
Marietta, GA 30060-1177
Phone: (770) 422-3290
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12643 (GA)

Record details

NPI number1316753254
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 5, 2024
Last updated in NPPESDecember 5, 2024
Certification dateDecember 5, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Resurgens, Llc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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