Provider Demographics
NPI:1902678261
Name:SANDERS, DELVALENCIA (STNA)
Entity Type:Individual
Prefix:
First Name:DELVALENCIA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1596 CRAWFORD RD APT 4
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-6303
Mailing Address - Country:US
Mailing Address - Phone:440-653-7490
Mailing Address - Fax:
Practice Address - Street 1:1596 CRAWFORD RD APT 4
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-6303
Practice Address - Country:US
Practice Address - Phone:440-653-7490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH601929051023376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide