Provider Demographics
NPI:1902478415
Name:TETTEH-ASSIAKOLEY, DELALI ADJELE (CRNP-FAMILY)
Entity Type:Individual
Prefix:
First Name:DELALI
Middle Name:ADJELE
Last Name:TETTEH-ASSIAKOLEY
Suffix:
Gender:F
Credentials:CRNP-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR STE 208
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7738
Mailing Address - Country:US
Mailing Address - Phone:410-821-7552
Mailing Address - Fax:
Practice Address - Street 1:7505 OSLER DR STE 208
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7738
Practice Address - Country:US
Practice Address - Phone:410-821-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR184207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily