Healthcare Provider Details

I. General information

NPI: 1659756229
Provider Name (Legal Business Name): HOLLY N WILLEY APRN-FNP/BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: H NOEL WARREN WILLEY APRN-FNP/BC

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34434 KING STREET ROW SUITE 2 DELAWARE NEUROLOGY ASSOCIATES
LEWES DE
19958-4787
US

IV. Provider business mailing address

34434 KING STREET ROW SUITE 2 DELAWARE NEUROLOGY ASSOCIATES
LEWES DE
19958-4787
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-8880
  • Fax: 302-644-8882
Mailing address:
  • Phone: 302-644-8880
  • Fax: 302-644-8882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG0000868
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: