Provider Demographics
NPI:1194340869
Name:DELOGLOS, STEPHENIA MARIE (CNM)
Entity type:Individual
Prefix:
First Name:STEPHENIA
Middle Name:MARIE
Last Name:DELOGLOS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 KITCHAWAM CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-7816
Mailing Address - Country:US
Mailing Address - Phone:804-310-8546
Mailing Address - Fax:
Practice Address - Street 1:7603 FOREST AVE STE 207
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4937
Practice Address - Country:US
Practice Address - Phone:804-523-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife