Healthcare Provider Details

I. General information

NPI: 1750797635
Provider Name (Legal Business Name): STEPHANIE A KLAIR ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2014
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 CHAPMAN RD SUITE 150
NEWARK DE
19702-5436
US

IV. Provider business mailing address

PO BOX 30170
WILMINGTON DE
19805-7170
US

V. Phone/Fax

Practice location:
  • Phone: 302-366-1929
  • Fax:
Mailing address:
  • Phone: 302-623-1929
  • Fax: 302-366-1075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLP0000109
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: