Healthcare Provider Details

I. General information

NPI: 1013970730
Provider Name (Legal Business Name): KIMBERLY D DELANO C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BAKER POND RD
CHARLTON MA
01507-6529
US

IV. Provider business mailing address

75 BAKER POND RD
CHARLTON MA
01507-6529
US

V. Phone/Fax

Practice location:
  • Phone: 508-248-4850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA36643
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8876
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN208057
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: