Provider Demographics
NPI:1790885317
Name:ENDICOTT, DELIA Y (ACNP)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:Y
Last Name:ENDICOTT
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:DELIA
Other - Middle Name:
Other - Last Name:YANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1200 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5049
Practice Address - Country:US
Practice Address - Phone:804-828-9205
Practice Address - Fax:804-828-8321
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167071363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care