Provider Demographics
NPI:1174043731
Name:DE LAROSA, GIAVANNA N (APRN-CNP)
Entity type:Individual
Prefix:
First Name:GIAVANNA
Middle Name:N
Last Name:DE LAROSA
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:GIAVANNA
Other - Middle Name:N
Other - Last Name:DE LAROSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:335 GLESSNER AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2269
Practice Address - Country:US
Practice Address - Phone:419-756-2003
Practice Address - Fax:419-756-3637
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0244680Medicaid