Doctor Name: | MRS. LESLEY ANN DELILLE |
NPI Number: | 1972885903 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N., N.P. |
License Number: | 4704256234 |
Business Practice Address: | 52375 N Main St Mattawan, MI - 490719332 |
Business Phone Number: | 2696683348 |
Business Fax Number: | 2696687702 |
Mailing Address: | 52375 N Main St, MATTAWAN |
State: | MI |
Postal Code: | 490719332 |
Phone Number: | 2696683348 |
Fax Number: | 2696687702 |
NPI Enumeration Date: | 09/15/2011 |
NPI Last Update Date: | 11/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704256234 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |