Provider Demographics
NPI:1306560701
Name:DELSERRO, ASHLEY (CRNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DELSERRO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 TUCK ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7446
Mailing Address - Country:US
Mailing Address - Phone:223-365-1668
Mailing Address - Fax:
Practice Address - Street 1:900 TUCK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7446
Practice Address - Country:US
Practice Address - Phone:223-365-1668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026349363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health