Provider Demographics
NPI:1275062150
Name:DELGADO ALAZO, MARIANYS (NP)
Entity Type:Individual
Prefix:
First Name:MARIANYS
Middle Name:
Last Name:DELGADO ALAZO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26493 E UNIVERSITY DR APT 1037
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1671
Mailing Address - Country:US
Mailing Address - Phone:206-771-1667
Mailing Address - Fax:
Practice Address - Street 1:275 GRANDVIEW AVE STE 104
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1742
Practice Address - Country:US
Practice Address - Phone:717-461-2264
Practice Address - Fax:717-204-4831
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020482363LP0808X, 163WP0808X
GURE2467163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health