Healthcare Provider Details

I. General information

NPI: 1124276886
Provider Name (Legal Business Name): ANA LUISA DELGADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 O ST STE 104
LINCOLN NE
68510-2468
US

IV. Provider business mailing address

5401 SOUTH ST
LINCOLN NE
68506-2150
US

V. Phone/Fax

Practice location:
  • Phone: 402-853-0993
  • Fax: 402-853-0197
Mailing address:
  • Phone: 402-413-3531
  • Fax: 402-413-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN11596
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME 110205
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number27486
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: