Individual
TESSA DELANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0003234
CO
152W00000X
Optometrist
Primary
122140
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679013
—
AK
01
—
K168657
MEDICARE AK
AK
Enumeration date
05/26/2017
Last updated
11/13/2020
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