Provider Demographics
NPI:1568026391
Name:NORA, DELLIRAY NEDIE
Entity Type:Individual
Prefix:
First Name:DELLIRAY
Middle Name:NEDIE
Last Name:NORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 FAIRVIEW ST APT 201
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3245
Mailing Address - Country:US
Mailing Address - Phone:757-418-5947
Mailing Address - Fax:757-644-6469
Practice Address - Street 1:3103 FAIRVIEW ST APT 201
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3245
Practice Address - Country:US
Practice Address - Phone:757-418-5947
Practice Address - Fax:757-644-6469
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA08115251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health