Provider Demographics
NPI:1972988335
Name:DESHIELDS, DELENA (RN, MSN/HCM)
Entity Type:Individual
Prefix:MS
First Name:DELENA
Middle Name:
Last Name:DESHIELDS
Suffix:
Gender:F
Credentials:RN, MSN/HCM
Other - Prefix:MS
Other - First Name:DELENA
Other - Middle Name:ANGELA
Other - Last Name:DESHIELDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, MSN/HCM
Mailing Address - Street 1:7055 SAMUEL MORSE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3439
Mailing Address - Country:US
Mailing Address - Phone:410-910-6700
Mailing Address - Fax:
Practice Address - Street 1:7055 SAMUEL MORSE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3439
Practice Address - Country:US
Practice Address - Phone:410-910-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162225163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse