Healthcare Provider Details

I. General information

NPI: 1033580600
Provider Name (Legal Business Name): JILL CAVALCANTI R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 SACKARACKIN AVE
DOVER DE
19901-4457
US

IV. Provider business mailing address

51 SACKARACKIN AVE
DOVER DE
19901-4457
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License NumberL1-0041722
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: