Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Destefano, CRNP

Individual provider Gerontology Nurse Practitioner · NPI 1982434908

Nicole Destefano, CRNP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2024, 2 years ago. Practices with University of Penn-Medical Group, a 3,401-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2024
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

3400 Spruce St
Philadelphia, PA 19104-4238
Phone: (215) 662-2366
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence SP030151 (PA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence SP030151 (PA)

Record details

NPI number1982434908
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedAugust 5, 2024
Last updated in NPPESFebruary 25, 2026
Certification dateFebruary 25, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice University Of Penn-Medical Group — 3401 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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