Provider Demographics
NPI:1124396015
Name:DELUHERY, SCARLET (LPN)
Entity Type:Individual
Prefix:
First Name:SCARLET
Middle Name:
Last Name:DELUHERY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2077 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-7833
Mailing Address - Country:US
Mailing Address - Phone:309-382-2006
Mailing Address - Fax:309-382-2007
Practice Address - Street 1:2077 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-7833
Practice Address - Country:US
Practice Address - Phone:309-382-2006
Practice Address - Fax:309-382-2007
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043111149163WP0808X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health