Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704230713 | MI |
Y | 363L00000X | Nurse Practitioner | 77380 | KS |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704230713 | MI |
NPI | 1073845517 |
---|---|
Provider Name | Deanna Michelle Delli-Pizzi |
First Address | Manhattan, KS 66502-2770 |
Second Address | Manhattan, KS 66502-2770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2010 |
Last Update Date | 20/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
068002426 | MEDICARE PTAN (01) | KS |
201143410A | (05) | KS |