Provider Demographics
NPI:1558854836
Name:DELGADO, KAROL VANESSA (CNP)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:VANESSA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GOVE ST
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-1920
Mailing Address - Country:US
Mailing Address - Phone:617-568-4872
Mailing Address - Fax:617-568-4756
Practice Address - Street 1:20 MAVERICK SQ
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2335
Practice Address - Country:US
Practice Address - Phone:617-569-5800
Practice Address - Fax:617-568-4418
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2282148363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health