Healthcare Provider Details

I. General information

NPI: 1902723232
Provider Name (Legal Business Name): JONATHAN DELPH DNAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 12TH ST
PRINCETON WV
24740-2312
US

IV. Provider business mailing address

2075 ENSLOW BLVD
HUNTINGTON WV
25701-4947
US

V. Phone/Fax

Practice location:
  • Phone: 304-487-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number108113
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: