Provider Demographics
NPI:1407443385
Name:DELEON, KARYSSA LISETTE (LVN)
Entity Type:Individual
Prefix:
First Name:KARYSSA
Middle Name:LISETTE
Last Name:DELEON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-1301
Mailing Address - Country:US
Mailing Address - Phone:830-426-0862
Mailing Address - Fax:
Practice Address - Street 1:809 11TH ST
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-1301
Practice Address - Country:US
Practice Address - Phone:830-426-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018239164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse