Healthcare Provider Details

I. General information

NPI: 1487001681
Provider Name (Legal Business Name): JAMIE DELLESKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 MELROSE AVE
COLUMBUS OH
43202-1307
US

IV. Provider business mailing address

563 MELROSE AVE
COLUMBUS OH
43202-1307
US

V. Phone/Fax

Practice location:
  • Phone: 412-218-9047
  • Fax:
Mailing address:
  • Phone: 412-218-9047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number15090008
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number151522R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: