Healthcare Provider Details

I. General information

NPI: 1811185432
Provider Name (Legal Business Name): LEISHA ANN DELMONICO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4507
US

IV. Provider business mailing address

PO BOX 766
INDIAN HILLS CO
80454-0766
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax:
Mailing address:
  • Phone: 303-716-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number177613
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: