Healthcare Provider Details

I. General information

NPI: 1598006504
Provider Name (Legal Business Name): TONYA DELANO N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 1ST STREET
LIMON CO
80828
US

IV. Provider business mailing address

820 1ST STREET
LIMON CO
80828
US

V. Phone/Fax

Practice location:
  • Phone: 719-775-2367
  • Fax: 719-775-8626
Mailing address:
  • Phone: 719-775-2367
  • Fax: 719-775-8626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0990669
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: