Provider Demographics
NPI:1821537200
Name:DELANEY-DAVIS, JENNIFER S (NP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:DELANEY-DAVIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5721
Mailing Address - Country:US
Mailing Address - Phone:228-872-1951
Mailing Address - Fax:228-875-9998
Practice Address - Street 1:2 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5721
Practice Address - Country:US
Practice Address - Phone:228-872-1951
Practice Address - Fax:228-875-9998
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901964363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS901964OtherMISSISSIPPI BOARD OF NURSING