Provider Demographics
NPI:1790091072
Name:DELPERCIO, CORA LEE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CORA
Middle Name:LEE
Last Name:DELPERCIO
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 1:2749 BRYTON DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7404
Mailing Address - Country:US
Mailing Address - Phone:614-537-1117
Mailing Address - Fax:
Practice Address - Street 1:2749 BRYTON DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7404
Practice Address - Country:US
Practice Address - Phone:614-537-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN099238164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse