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General NPI Number Information
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NPI Number | 1891504924
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Entity Type | Individual
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Provider Name | DELANY IVY
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1500 S MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4917
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Country | US
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Telephone | 817-702-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 2119 CHANCE LN
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City | NORTHLAKE
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State | TX
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Zip | 76247-2694
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Country | US
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Telephone | 903-818-1489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 945375
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License Number State | TX
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