Healthcare Provider Details

I. General information

NPI: 1962291583
Provider Name (Legal Business Name): OLGA DELGRANDE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 TOWER RD STE 3188
BRISTOL PA
19007-3116
US

IV. Provider business mailing address

909 RIDGEBROOK RD STE 300
SPARKS GLENCOE MD
21152-9477
US

V. Phone/Fax

Practice location:
  • Phone: 443-483-9300
  • Fax: 443-483-9300
Mailing address:
  • Phone: 443-383-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP032588
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: