Provider Demographics
NPI:1235581109
Name:DELANEY, CONNIE JEAN (RN)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:JEAN
Last Name:DELANEY
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 1:308 HARVARD ST SE
Mailing Address - Street 2:5-140 WDH
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0353
Mailing Address - Country:US
Mailing Address - Phone:612-624-5959
Mailing Address - Fax:
Practice Address - Street 1:308 HARVARD ST SE
Practice Address - Street 2:5-140 WDH
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0353
Practice Address - Country:US
Practice Address - Phone:612-624-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR88266-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse