Provider Demographics
NPI:1700337953
Name:DELVA, JENNYFER
Entity Type:Individual
Prefix:
First Name:JENNYFER
Middle Name:
Last Name:DELVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 COLUMBIANA RD
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2153
Mailing Address - Country:US
Mailing Address - Phone:205-536-8400
Mailing Address - Fax:
Practice Address - Street 1:20 BRADSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2705
Practice Address - Country:US
Practice Address - Phone:617-635-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant