Individual
DELESA R BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 METRO PL N STE 300, DUBLIN, OH 43017-5320
(855) 289-1722
Mailing address
525 METRO PL N STE 300, DUBLIN, OH 43017-5320
(855) 289-1722
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
PN156549
OH
164W00000X
Licensed Practical Nurse
Primary
LPN.156549.MEDS-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
09/13/2021
Last updated
11/03/2025
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