Provider Demographics
NPI:1063045797
Name:DELGADO, DJUANA CABEZA DE BACA (RN)
Entity Type:Individual
Prefix:MS
First Name:DJUANA
Middle Name:CABEZA DE BACA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 MCCABE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-5150
Mailing Address - Country:US
Mailing Address - Phone:915-490-0684
Mailing Address - Fax:
Practice Address - Street 1:9100 MCCABE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5150
Practice Address - Country:US
Practice Address - Phone:915-490-0684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX547006163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse