Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 25777 | NE |
NPI | 1518178680 |
---|---|
Provider Name | Ms. Shirley Fenelonne Delair |
First Address | Omaha, NE 68114-4113 |
Second Address | Omaha, NE 68198-2162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 15/04/2015 |