Provider Demographics
NPI:1275684565
Name:DELAPENHA, PAULETTE ANJENIE (DNP,CRNP)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:ANJENIE
Last Name:DELAPENHA
Suffix:
Gender:F
Credentials:DNP,CRNP
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 198
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-0198
Mailing Address - Country:US
Mailing Address - Phone:301-655-2010
Mailing Address - Fax:
Practice Address - Street 1:1160 VARNUM ST.
Practice Address - Street 2:SUITE 016
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-526-8622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN47984363L00000X
MDR088887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily