Healthcare Provider Details

I. General information

NPI: 1962001180
Provider Name (Legal Business Name): KAITLIN MARIE FIELDER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W CLARKE AVE STE 1410
MILFORD DE
19963-1857
US

IV. Provider business mailing address

21 W CLARKE AVE STE 1410
MILFORD DE
19963-1857
US

V. Phone/Fax

Practice location:
  • Phone: 302-467-3200
  • Fax: 302-412-4373
Mailing address:
  • Phone: 302-467-3200
  • Fax: 302-412-4373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011521
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: