Provider Demographics
NPI:1467261552
Name:ELEY, DELOIS Q (LPN)
Entity type:Individual
Prefix:
First Name:DELOIS
Middle Name:Q
Last Name:ELEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FORT PLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:13339-1228
Mailing Address - Country:US
Mailing Address - Phone:518-914-8058
Mailing Address - Fax:
Practice Address - Street 1:66 CENTER ST
Practice Address - Street 2:
Practice Address - City:FORT PLAIN
Practice Address - State:NY
Practice Address - Zip Code:13339-1228
Practice Address - Country:US
Practice Address - Phone:518-914-8058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349537164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse