Healthcare Provider Details

I. General information

NPI: 1508761594
Provider Name (Legal Business Name): DELTA TOXICOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E TELEGRAPH ST
CARSON CITY NV
89701-4215
US

IV. Provider business mailing address

PO BOX 1607
CRYSTAL BAY NV
89402-1607
US

V. Phone/Fax

Practice location:
  • Phone: 775-200-5256
  • Fax:
Mailing address:
  • Phone: 775-200-5256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. KATHRYN E KELLY
Title or Position: PRESIDENT
Credential: DRPH
Phone: 775-200-5256