Provider Demographics
NPI:1417515321
Name:BRATHWAITE DELPESCHE, ALLISON DELORES (DNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:DELORES
Last Name:BRATHWAITE DELPESCHE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6861
Mailing Address - Country:US
Mailing Address - Phone:561-373-8027
Mailing Address - Fax:
Practice Address - Street 1:138 HERITAGE WAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6861
Practice Address - Country:US
Practice Address - Phone:561-373-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9170081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily