Provider Demographics
NPI:1710278346
Name:DELISLE, MARC B (RN)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:B
Last Name:DELISLE
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Gender:M
Credentials:RN
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Mailing Address - Street 1:7660 E MCKELLIPS RD
Mailing Address - Street 2:LOT 80
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4624
Mailing Address - Country:US
Mailing Address - Phone:480-214-5401
Mailing Address - Fax:480-214-5401
Practice Address - Street 1:7660 E MCKELLIPS RD
Practice Address - Street 2:LOT 80
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4624
Practice Address - Country:US
Practice Address - Phone:480-214-5401
Practice Address - Fax:480-214-5401
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-30
Last Update Date:2011-04-30
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Provider Licenses
StateLicense IDTaxonomies
AZRN117104163WH0200X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult