Healthcare Provider Details

I. General information

NPI: 1154308849
Provider Name (Legal Business Name): JAMES WITT DELANEY FNP-B.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 HIGHWAY 114 S
SCOTTS HILL TN
38374-5023
US

IV. Provider business mailing address

PO BOX 187
SCOTTS HILL TN
38374-0187
US

V. Phone/Fax

Practice location:
  • Phone: 731-847-6396
  • Fax: 731-847-4511
Mailing address:
  • Phone: 731-614-1034
  • Fax: 731-549-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number7166
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: