Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Jul 16, 2020
License(s)
LG-0001358 (DE), SP021902 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1802 W 4TH ST | Wilmington, DE 19805-3420 | 302-652-2455 |
| MAILING | PO BOX 151 | New Castle, DE 19720-0151 | 302-652-2455 |
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