Healthcare Provider Details

I. General information

NPI: 1033100748
Provider Name (Legal Business Name): MICHELLE L LEITE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S QUEEN ST STE 102
DOVER DE
19904-3568
US

IV. Provider business mailing address

725 S QUEEN ST STE 102
DOVER DE
19904-3568
US

V. Phone/Fax

Practice location:
  • Phone: 302-401-1005
  • Fax: 302-439-6226
Mailing address:
  • Phone: 302-401-1005
  • Fax: 302-363-4293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0000289
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG0000289
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010571
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: