Provider Demographics
NPI:1568552586
Name:FYNBO, DELYA
Entity Type:Individual
Prefix:
First Name:DELYA
Middle Name:
Last Name:FYNBO
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 1:107 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:SCARVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50473-7700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 LOGAN AVE.
Practice Address - Street 2:
Practice Address - City:SCARVILLE
Practice Address - State:IA
Practice Address - Zip Code:50473-7700
Practice Address - Country:US
Practice Address - Phone:507-402-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant