Healthcare Provider Details

I. General information

NPI: 1093106478
Provider Name (Legal Business Name): BAYHEALTH NEUROSURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S GOVERNORS AVE SUITE 100
DOVER DE
19904-3530
US

IV. Provider business mailing address

11 S TURNBERRY DR
DOVER DE
19904-2348
US

V. Phone/Fax

Practice location:
  • Phone: 302-526-1470
  • Fax:
Mailing address:
  • Phone: 302-382-1131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberLP-0000127
License Number StateDE

VIII. Authorized Official

Name: MEGHAN BRYNN SCHEPENS
Title or Position: NURSE PRACTITIONER
Credential: ANP
Phone: 302-382-1131