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Individual
NICOLE DELLISE
Active
Individual
NICOLE DELLISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0000017430
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1532825
—
TN
01
—
6011929
BLUE CROSS/BLUE SHIELD
TN
01
—
P01376514
RR MEDICARE
TN
Enumeration date
05/21/2013
Last updated
10/07/2021
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