Individual
DELANEY ELISABETH PROVENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 SHEPHERD ST STE 300, WINSTON SALEM, NC 27103-1633
(336) 713-7777
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-8250
(336) 713-8588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11392
NC
363AM0700X
Medical Physician Assistant
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—
Other
Enumeration date
06/03/2021
Last updated
10/11/2024
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