Healthcare Provider Details

I. General information

NPI: 1306043906
Provider Name (Legal Business Name): BETHANIE S DELANEY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 RUE DE LA VIE ST STE 310
BATON ROUGE LA
70817-5128
US

IV. Provider business mailing address

9001 SUMMA AVE
BATON ROUGE LA
70809-3726
US

V. Phone/Fax

Practice location:
  • Phone: 225-201-0505
  • Fax:
Mailing address:
  • Phone: 225-761-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN.096454
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: