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General NPI Number Information
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NPI Number | 1114695293
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Entity Type | Individual
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Provider Name | RASA DELETRAIN APRN-FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 507 CAPE CORAL PKWY E
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City | CAPE CORAL
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State | FL
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Zip | 33904-8545
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Country | US
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Telephone | 239-541-4420
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Fax | 239-424-4421
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-541-4420
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Fax | 239-541-4421
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9375536
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11015251
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License Number State | FL
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