Healthcare Provider Details

I. General information

NPI: 1881080927
Provider Name (Legal Business Name): DALISA DELK R.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 ROSEWOOD AVE
LAKEWOOD OH
44107-3737
US

IV. Provider business mailing address

1621 ROSEWOOD AVE
LAKEWOOD OH
44107-3737
US

V. Phone/Fax

Practice location:
  • Phone: 216-577-2702
  • Fax:
Mailing address:
  • Phone: 216-577-2702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN.394182
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: