Provider Demographics
NPI:1992733166
Name:DELANEY, JENNIFER JEAN (DO)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:DELANEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JEAN
Other - Last Name:VIERTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1140 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4161
Mailing Address - Country:US
Mailing Address - Phone:919-775-2304
Mailing Address - Fax:919-775-4050
Practice Address - Street 1:1140 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4161
Practice Address - Country:US
Practice Address - Phone:919-775-2304
Practice Address - Fax:919-775-4050
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63573207V00000X
NC200501812207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902474Medicaid
NC5902474Medicaid
NCI24775Medicare UPIN