| Doctor Name: | VICKIE LEA DELERUYELLE |
| NPI Number: | 1023013430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | NP08290 |
| Business Practice Address: | 151 Anderson Ln Waterford, OH - 457865312 |
| Business Phone Number: | 7409842332 |
| Business Fax Number: | 7409844435 |
| Mailing Address: | Po Box 449, MARIETTA |
| State: | OH |
| Postal Code: | 457500449 |
| Phone Number: | 7403744500 |
| Fax Number: | 7403745887 |
| NPI Enumeration Date: | 06/14/2005 |
| NPI Last Update Date: | 01/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP08290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |