Healthcare Provider Details

I. General information

NPI: 1407629207
Provider Name (Legal Business Name): SARA K LAMONICA WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 OGLETOWN STANTON RD STE 1109
NEWARK DE
19713-2089
US

IV. Provider business mailing address

4735 OGLETOWN STANTON RD STE 1109
NEWARK DE
19713-2089
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-4175
  • Fax: 302-623-3841
Mailing address:
  • Phone: 302-623-4175
  • Fax: 302-623-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number089859-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberLH-0010281
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: