Healthcare Provider Details

I. General information

NPI: 1215570411
Provider Name (Legal Business Name): FEEAH M REED-STEWART CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 S STATE ST
DOVER DE
19901-5148
US

IV. Provider business mailing address

818 ASHBY DR
MIDDLETOWN DE
19709-9951
US

V. Phone/Fax

Practice location:
  • Phone: 302-257-3135
  • Fax:
Mailing address:
  • Phone: 215-803-2792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001325
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: