MEDICARE: KARENA FAYE DELVECCHIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0028422	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.0028422	OH

General Provider Information

NPI Number	:	1780277079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARENA FAYE DELVECCHIO

Provider Business Mailing Address
First Line	:	502 CABELA DR
Second Line	:
City	:	TRIADELPHIA
State	:	WV
Zip	:	26059-1044
Country	:	US
Telephone Number	:	304-312-0416
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 CABELA DR
Second Line	:
City	:	TRIADELPHIA
State	:	WV
Zip	:	26059-1044
Country	:	US
Telephone Number	:	304-312-0416
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2021
Last Update Date	:	02/12/2026

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