Provider Demographics
NPI:1306566096
Name:DELIGHT-MCCANN, NICOLE ADELLA (FNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ADELLA
Last Name:DELIGHT-MCCANN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3421
Mailing Address - Country:US
Mailing Address - Phone:716-699-9032
Mailing Address - Fax:716-699-9035
Practice Address - Street 1:1438 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3421
Practice Address - Country:US
Practice Address - Phone:716-699-9032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350141-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily