Provider Demographics
NPI:1619351863
Name:DELANEY, DEANGELA LENORE (NP)
Entity Type:Individual
Prefix:
First Name:DEANGELA
Middle Name:LENORE
Last Name:DELANEY
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 1:703 POINSETTIA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2066
Mailing Address - Country:US
Mailing Address - Phone:803-240-3030
Mailing Address - Fax:803-771-2822
Practice Address - Street 1:2739 LAUREL STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205
Practice Address - Country:US
Practice Address - Phone:803-799-4800
Practice Address - Fax:803-252-0052
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily