Provider Demographics
NPI:1093800146
Name:DELISIO, CARYN L (RN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:CARYN
Middle Name:L
Last Name:DELISIO
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 HOAG DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1492
Mailing Address - Country:US
Mailing Address - Phone:144-093-0604
Mailing Address - Fax:330-723-8357
Practice Address - Street 1:5319 HOAG DR STE 100
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1492
Practice Address - Country:US
Practice Address - Phone:440-930-6015
Practice Address - Fax:440-930-6094
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08496363LA2200X
OHNP08496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health