Provider Demographics
NPI:1811348527
Name:DELANEY, AMY LOUISE (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LOUISE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:LOUISE
Other - Last Name:CUSACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 GLEN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-1882
Mailing Address - Country:US
Mailing Address - Phone:978-988-9669
Mailing Address - Fax:
Practice Address - Street 1:75 GLEN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-1882
Practice Address - Country:US
Practice Address - Phone:978-988-9669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204530163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse