Individual
KELLY DELANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
Mailing address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
243961-30
WI
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
243961-30
WI
164W00000X
Licensed Practical Nurse
322189-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42030700
—
WI
Enumeration date
05/08/2018
Last updated
05/02/2024
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