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Individual

MS. AGNES BLANCHE DELANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
850 WH SMITH BLVD, GREENVILLE, NC 27834-3763
(252) 758-3211
Mailing address
850 WH SMITH BLVD, GREENVILLE, NC 27834-3763
(527) 583-2112

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001009744
NC
363A00000X
Physician Assistant
085002145
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
85002145
STATE LICENSE
IL
Enumeration date
05/27/2005
Last updated
01/13/2022
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