Provider Demographics
NPI:1780451757
Name:ROSS, DELANEY ROSE FIONA (PA)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:ROSE FIONA
Last Name:ROSS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:ROSE
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:407 ULUNIU ST STE 411
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2544
Mailing Address - Country:US
Mailing Address - Phone:775-219-0943
Mailing Address - Fax:
Practice Address - Street 1:407 ULUNIU ST STE 411
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2544
Practice Address - Country:US
Practice Address - Phone:775-219-0943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant