Healthcare Provider Details

I. General information

NPI: 1831435536
Provider Name (Legal Business Name): NANCY KATHERINE HOMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON ROAD
NEWARK DE
19734
US

IV. Provider business mailing address

4755 OGLETOWN STANTON ROAD
NEWARK DE
19734
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1813
  • Fax: 302-733-1633
Mailing address:
  • Phone: 302-733-1813
  • Fax: 302-733-1633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberL10019000
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: