Provider Demographics
NPI:1225728496
Name:PEASE, DELANEY RAE (GC)
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:RAE
Last Name:PEASE
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:RAE
Other - Last Name:COY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4146 MEADOW PKWY APT C
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-6403
Mailing Address - Country:US
Mailing Address - Phone:218-269-5180
Mailing Address - Fax:
Practice Address - Street 1:915 E 1ST ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2107
Practice Address - Country:US
Practice Address - Phone:218-269-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS