Provider Demographics
NPI:1053769133
Name:DELANEY, RAE MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:RAE
Middle Name:MARIE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BERTHA HOWE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-7503
Mailing Address - Country:US
Mailing Address - Phone:702-346-0800
Mailing Address - Fax:
Practice Address - Street 1:1301 BERTHA HOWE AVE STE 1
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-7503
Practice Address - Country:US
Practice Address - Phone:702-346-4302
Practice Address - Fax:702-346-0118
Is Sole Proprietor?:No
Enumeration Date:2016-05-30
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28139816A163W00000X
NV861266207Q00000X, 363LF0000X
MI4704269369363LF0000X, 163W00000X
IN71006752A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine