Healthcare Provider Details

I. General information

NPI: 1679187181
Provider Name (Legal Business Name): SHEILA LEE DIROCCO APRN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

26982 MARYDEL RD
MARYDEL MD
21649-1413
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-6223
  • Fax:
Mailing address:
  • Phone: 302-233-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SR0400X
TaxonomyRehabilitation Clinical Nurse Specialist
License NumberL1-0024177
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: