Provider Demographics
NPI:1992080824
Name:DELONG, TRISHA ANNE (NP)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANNE
Last Name:DELONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2811
Mailing Address - Country:US
Mailing Address - Phone:513-892-1888
Mailing Address - Fax:513-892-2054
Practice Address - Street 1:210 S 2ND ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2811
Practice Address - Country:US
Practice Address - Phone:513-892-1888
Practice Address - Fax:513-892-2054
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 12778-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily