Provider Demographics
NPI:1871662130
Name:DELP, JEANAN (CNM)
Entity Type:Individual
Prefix:
First Name:JEANAN
Middle Name:
Last Name:DELP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JEANAN
Other - Middle Name:S
Other - Last Name:SLUSHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:6911 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8926
Mailing Address - Country:US
Mailing Address - Phone:317-272-8033
Mailing Address - Fax:317-272-8044
Practice Address - Street 1:6911 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8926
Practice Address - Country:US
Practice Address - Phone:317-272-8033
Practice Address - Fax:317-272-8044
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN72000117A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200448140Medicaid