Individual
NICOLE MARIE DELISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
234 AMY AVE, LOUISVILLE, KY 40212-2522
(502) 778-0001
Mailing address
234 AMY AVE, LOUISVILLE, KY 40212-2522
(502) 778-0001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1127180
KY
163W00000X
Registered Nurse
561536
NY
363LF0000X
Family Nurse Practitioner
Primary
3008359
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100305860
—
KY
Enumeration date
10/20/2010
Last updated
06/17/2016
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