Healthcare Provider Details

I. General information

NPI: 1285404012
Provider Name (Legal Business Name): STACEY DELUKEY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST FL 2
DOVER DE
19901-3530
US

IV. Provider business mailing address

640 S STATE ST # MC3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-7994
  • Fax: 302-744-7993
Mailing address:
  • Phone: 302-480-1688
  • Fax: 302-480-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010581
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: