Healthcare Provider Details
I. General information
NPI: 1538198130
Provider Name (Legal Business Name): CAROLYN S DELOE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1275 YORK RD STE 17
GETTYSBURG PA
17325-7565
US
IV. Provider business mailing address
116 S GEORGE ST
YORK PA
17401-1474
US
V. Phone/Fax
- Phone: 717-337-9400
- Fax: 717-337-1205
- Phone: 717-846-5846
- Fax: 717-854-0377
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R152040 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP006628B |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: