Provider Demographics
NPI:1992586622
Name:SWANSON, DELANEY (LVN)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:
Other - Last Name:THIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8086 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-5941
Mailing Address - Country:US
Mailing Address - Phone:530-908-3839
Mailing Address - Fax:
Practice Address - Street 1:8086 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-5941
Practice Address - Country:US
Practice Address - Phone:530-908-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA719170164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse