Healthcare Provider Details

I. General information

NPI: 1689735466
Provider Name (Legal Business Name): CATHERINE ANN DELANEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SANDOVAL RD SW
LOS LUNAS NM
87031-7320
US

IV. Provider business mailing address

PO BOX 26028
ALBUQUERQUE NM
87125-6028
US

V. Phone/Fax

Practice location:
  • Phone: 505-565-4355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number91-PA11
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: