Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3003069 | KY |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 3069P | KY |
NPI | 1083616064 |
---|---|
Provider Name | Debra Dellay |
First Address | Lexington, KY 40502-2915 |
Second Address | Lexington, KY 40513-1175 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 02/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S92405 | (02) | KY |