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General NPI Number Information
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NPI Number | 1033554233
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Entity Type | Organization
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Legal Business Name | DELTA HEALTH AND WELLNESS CENTER
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 1025 MAIN STREET
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City | DELTA
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State | CO
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Zip | 81416
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Country | US
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Telephone | 970-964-7740
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Fax | 970-874-6330
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Provider Business Mailing Address
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Address Line | 1025 MAIN STREET
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City | DELTA
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State | CO
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Zip | 81416
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Country | US
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Telephone | 970-964-7740
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Fax | 970-874-6330
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Authorized Official
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Title or Position | HEALTH SERVICES ADMINISTRATOR
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Name | ALICEMARIE SLAVEN-EMOND
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Credential | FNP-C
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Telephone | 970-964-7740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | C-APN 2573
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License Number State | CO
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