MEDICARE: JENNIFER DELANEY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	APRN16216	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.16216	OH
3	363LA2200X	Adult Health Nurse Practitioner	16216.NP	OH
4	363LG0600X	Gerontology Nurse Practitioner	APRN16216	OH
5	363LP2300X	Primary Care Nurse Practitioner	APRN16216	OH

General Provider Information

NPI Number	:	1942617527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER DELANEY NP

Provider Business Mailing Address
First Line	:	6855 SPRING VALLEY DR STE 110
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-9374
Country	:	US
Telephone Number	:	218-438-0283
Fax Number	:

Provider Business Practice Location Address
First Line	:	6855 SPRING VALLEY DR STE 110
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-9374
Country	:	US
Telephone Number	:	218-438-1283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	01/28/2025

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