Provider Demographics
NPI:1912673716
Name:RONEY, DELAINA (APRN)
Entity Type:Individual
Prefix:
First Name:DELAINA
Middle Name:
Last Name:RONEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4590 SOUTHSIDE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHSIDE
Mailing Address - State:TN
Mailing Address - Zip Code:37171-9042
Mailing Address - Country:US
Mailing Address - Phone:615-772-3365
Mailing Address - Fax:
Practice Address - Street 1:651 DUNLOP LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5015
Practice Address - Country:US
Practice Address - Phone:931-502-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29855363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner