=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891701926
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTEN NANCY DELANY NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2006
-----------------------------------------------------
Last Update Date | 03/17/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 739 IRVING AVE SUITE 640
-----------------------------------------------------
City | SYRACUSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13210-1640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-299-8150
-----------------------------------------------------
Fax | 315-299-8155
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 739 IRVING AVE SUITE 640
-----------------------------------------------------
City | SYRACUSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13210-1640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-299-8150
-----------------------------------------------------
Fax | 315-299-8155
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 304457
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VX0000X
-----------------------------------------------------
Taxonomy Name | Obstetrics Physician
-----------------------------------------------------
License Number | 304457
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------