=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497649149
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOANNA DELGADILLO FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2025
-----------------------------------------------------
Last Update Date | 06/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6974 GATEWAY BLVD E STE F
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79915-1115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-591-2704
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14363 EDGEMERE BLVD APT 2908
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79938-5123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-490-8750
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1201591
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------