Healthcare Provider Details

I. General information

NPI: 1508760539
Provider Name (Legal Business Name): LORI ANN DELASCIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 S SEGOE RD
MADISON WI
53705-4953
US

IV. Provider business mailing address

1229 JASMINE DR
MADISON WI
53719-4520
US

V. Phone/Fax

Practice location:
  • Phone: 608-692-3433
  • Fax: 608-260-7816
Mailing address:
  • Phone: 608-692-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number1105339-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: