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Individual
VICKIE LEA DELERUYELLE
Active
Individual
VICKIE LEA DELERUYELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP08290
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000370964
ANTHEM
OH
01
—
000000699818
ANTHEM
OH
05
—
2588543
—
OH
05
—
3810002943
—
WV
01
—
P00231317
RRMCR
OH
Enumeration date
06/14/2005
Last updated
01/20/2012
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