Provider Demographics
NPI:1790765519
Name:SILVERMOON, DELPHINE (CNM)
Entity Type:Individual
Prefix:MS
First Name:DELPHINE
Middle Name:
Last Name:SILVERMOON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:DELPHINE
Other - Middle Name:P
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:9534 STATE ROUTE 682
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-9103
Mailing Address - Country:US
Mailing Address - Phone:740-952-9683
Mailing Address - Fax:888-284-7513
Practice Address - Street 1:9534 STATE ROUTE 682
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-9103
Practice Address - Country:US
Practice Address - Phone:740-952-9683
Practice Address - Fax:888-284-7513
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV59311367A00000X
WV121367A00000X
OHNM11352367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife