Individual
JEANENE E. DELONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4916 OVERTON PLZ, FORT WORTH, TX 76109
(888) 804-3000
(817) 334-0235
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
250841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088850503
—
TX
Enumeration date
05/12/2006
Last updated
06/06/2018
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