Healthcare Provider Details

I. General information

NPI: 1659372670
Provider Name (Legal Business Name): DELAWARE FAMILY HEALTHCARE ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 S DUPONT HWY
DOVER DE
19901-5129
US

IV. Provider business mailing address

136 TRAYBERN BLVD
CAMDEN DE
19934-1947
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-0515
  • Fax: 302-677-0415
Mailing address:
  • Phone: 302-677-0515
  • Fax: 302-677-0415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberLH000159
License Number StateDE

VIII. Authorized Official

Name: SANDRA NMI PATTERSON
Title or Position: ADVANCED PRACTICE NURSE
Credential: NP
Phone: 302-677-0515