Provider Demographics
NPI:1477378917
Name:DELMENDO, LAILA GRACE UMADHAY (RN)
Entity type:Individual
Prefix:
First Name:LAILA GRACE
Middle Name:UMADHAY
Last Name:DELMENDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6352 FREEPORT DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-3332
Mailing Address - Country:US
Mailing Address - Phone:720-453-9442
Mailing Address - Fax:
Practice Address - Street 1:2369 S TRENTON WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-7011
Practice Address - Country:US
Practice Address - Phone:303-671-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1653952163WD1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal