Provider Demographics
NPI:1891046397
Name:STANLEY, DELORES JEAN (CNM)
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:JEAN
Last Name:STANLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 E 600 N
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:IN
Mailing Address - Zip Code:46701-9725
Mailing Address - Country:US
Mailing Address - Phone:260-318-1195
Mailing Address - Fax:
Practice Address - Street 1:1427 S LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-2376
Practice Address - Country:US
Practice Address - Phone:260-318-1195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife