Healthcare Provider Details

I. General information

NPI: 1346075041
Provider Name (Legal Business Name): TRANQUIL MOMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S FARMVIEW DR APT C31
DOVER DE
19904-3386
US

IV. Provider business mailing address

1300 S FARMVIEW DR APT C31
DOVER DE
19904-3386
US

V. Phone/Fax

Practice location:
  • Phone: 302-883-2134
  • Fax:
Mailing address:
  • Phone: 302-883-2134
  • Fax: 302-342-0697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LEAH RENO PATTERSON
Title or Position: PMHNP/OWNER
Credential: NP
Phone: 302-883-2134