Healthcare Provider Details

I. General information

NPI: 1558166207
Provider Name (Legal Business Name): PATRICIA DEER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 S NEW ST
DOVER DE
19904-3540
US

IV. Provider business mailing address

100 WELLNESS WAY # 2165
MILFORD DE
19963-4364
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4070
  • Fax: 302-672-2315
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0013129
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: