Healthcare Provider Details

I. General information

NPI: 1871135681
Provider Name (Legal Business Name): CARISSA EMILY SWEENEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARISSA EMILY DEFILIPPO

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20930 DUPONT BLVD UNIT 202
GEORGETOWN DE
19947-1724
US

IV. Provider business mailing address

20930 DUPONT BLVD UNIT 202
GEORGETOWN DE
19947-1724
US

V. Phone/Fax

Practice location:
  • Phone: 302-202-3438
  • Fax: 302-267-4001
Mailing address:
  • Phone: 302-400-9999
  • Fax: 302-267-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR220072
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: