Healthcare Provider Details

I. General information

NPI: 1316183171
Provider Name (Legal Business Name): MS. RELONDIA DELANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 04/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1962 W HAMPTON AVE
MILWAUKEE WI
53209-5772
US

IV. Provider business mailing address

5388 N DEXTER AVE
MILWAUKEE WI
53209-5071
US

V. Phone/Fax

Practice location:
  • Phone: 414-372-9888
  • Fax: 414-372-9884
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number123571-030
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: