Provider Demographics
NPI:1346324670
Name:PRICE, DELVIN JOSEPH JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DELVIN
Middle Name:JOSEPH
Last Name:PRICE
Suffix:JR
Gender:M
Credentials:CRNA
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 614
Mailing Address - Street 2:
Mailing Address - City:SWARTZ
Mailing Address - State:LA
Mailing Address - Zip Code:71281-0614
Mailing Address - Country:US
Mailing Address - Phone:318-343-9590
Mailing Address - Fax:
Practice Address - Street 1:2229 HWY139
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-0614
Practice Address - Country:US
Practice Address - Phone:318-343-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN033769AP01625367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA59626Medicare ID - Type UnspecifiedCRNA