Healthcare Provider Details

I. General information

NPI: 1982359618
Provider Name (Legal Business Name): DECONTEE ZIAH BARLEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date: 02/28/2022
Reactivation Date: 03/17/2022

III. Provider practice location address

700 MARVEL RD
MILFORD DE
19963-1740
US

IV. Provider business mailing address

700 MARVEL RD
MILFORD DE
19963
US

V. Phone/Fax

Practice location:
  • Phone: 952-217-7743
  • Fax:
Mailing address:
  • Phone: 952-217-7743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010834
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0011903
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011903
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberL1-0054156
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: