Healthcare Provider Details

I. General information

NPI: 1619117496
Provider Name (Legal Business Name): MARY T PARSONS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28538 DUPONT BLVD
MILLSBORO DE
19966-4791
US

IV. Provider business mailing address

1515 SAVANNAH RD STE 103
LEWES DE
19958-1675
US

V. Phone/Fax

Practice location:
  • Phone: 302-934-5052
  • Fax:
Mailing address:
  • Phone: 302-313-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR126542
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG0000263
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: