Healthcare Provider Details

I. General information

NPI: 1528239118
Provider Name (Legal Business Name): TERESA LYNN MATTHEWS FNP-C, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2008
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 SE 2ND ST
MILFORD DE
19963-1577
US

IV. Provider business mailing address

919 SE 2ND ST
MILFORD DE
19963-1577
US

V. Phone/Fax

Practice location:
  • Phone: 302-363-5839
  • Fax: 302-424-7755
Mailing address:
  • Phone: 302-363-5839
  • Fax: 302-424-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000527
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0000527
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: