Healthcare Provider Details

I. General information

NPI: 1972816494
Provider Name (Legal Business Name): DOREEN A YIRENCHI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HYGEIA DR STE 1420
NEWARK DE
19713-2049
US

IV. Provider business mailing address

200 HYGEIA DR STE 1420
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-3017
  • Fax: 302-266-9962
Mailing address:
  • Phone: 302-623-3017
  • Fax: 302-266-9962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0055914
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335981-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001417
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: