Provider Demographics
NPI:1154308849
Name:DELANEY, JAMES WITT (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WITT
Last Name:DELANEY
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:SCOTTS HILL
Mailing Address - State:TN
Mailing Address - Zip Code:38374-0187
Mailing Address - Country:US
Mailing Address - Phone:731-614-1034
Mailing Address - Fax:731-549-1011
Practice Address - Street 1:644 HIGHWAY 114 S
Practice Address - Street 2:
Practice Address - City:SCOTTS HILL
Practice Address - State:TN
Practice Address - Zip Code:38374-5023
Practice Address - Country:US
Practice Address - Phone:731-847-6396
Practice Address - Fax:731-847-4511
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7166363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ003775Medicaid
Q24416Medicare UPIN