Individual
LERATO DENISE MODISELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
460 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-5066
(614) 293-7520
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-5066
(614) 293-7520
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.0038168
OH
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
APRN.CNP.0038168
OH
Other
Enumeration date
07/23/2025
Last updated
08/29/2025
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