Healthcare Provider Details

I. General information

NPI: 1104348796
Provider Name (Legal Business Name): HEATHER M. MILEA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S COLLEGE AVE STE 130
NEWARK DE
19713-1302
US

IV. Provider business mailing address

540 S COLLEGE AVE STE 130
NEWARK DE
19713-1302
US

V. Phone/Fax

Practice location:
  • Phone: 302-831-3195
  • Fax: 302-831-3193
Mailing address:
  • Phone: 302-831-3195
  • Fax: 302-831-3193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0026633
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001058
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: