Basic Information
Provider Information
NPI: 1194090050
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELANEY
FirstName: CAILIN
MiddleName: ANTONIA
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BRAZEAU
OtherFirstName: CAILIN
OtherMiddleName: ANTONIA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 110429
Address2:  
City: AURORA
State: CO
PostalCode: 800420429
CountryCode: US
TelephoneNumber: 3034937000
FaxNumber:  
Practice Location
Address1: 12605 E 16TH AVE
Address2: UNIVERSITY OF COLORADO HOSPITAL
City: AURORA
State: CO
PostalCode: 800452545
CountryCode: US
TelephoneNumber: 7208480000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/12/2012
LastUpdateDate: 07/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA.0004142CON Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000XPA9106351FLN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AS0400XPA.0004142COY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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