Provider Demographics
NPI:1871844597
Name:DELANEY, TERA LYNN (MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TERA
Middle Name:LYNN
Last Name:DELANEY
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:TERA
Other - Middle Name:LYNN
Other - Last Name:GORECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-BC
Mailing Address - Street 1:1417 9TH ST SOUTH
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-791-3200
Mailing Address - Fax:406-791-3230
Practice Address - Street 1:1417 9TH ST SOUTH
Practice Address - Street 2:SUITE 201
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-791-3200
Practice Address - Fax:406-791-3230
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT100591OtherMONTANA STATE LICENSE