Healthcare Provider Details

I. General information

NPI: 1265833354
Provider Name (Legal Business Name): SHERI ANNE SMITH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 W MAIN ST STE A
NEWARK DE
19711
US

IV. Provider business mailing address

1 CLOVER MILL DR
NEWARK DE
19702-2219
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-6800
  • Fax:
Mailing address:
  • Phone: 302-738-1809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000764
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: