Healthcare Provider Details

I. General information

NPI: 1417961228
Provider Name (Legal Business Name): NANCY LEE GAINES-DILLARD DNP, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY LEE GAINES-DILLARD DNP, APRN-BC

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 OGLETOWN STANTON ROAD SUITE 3301
NEWARK DE
19713
US

IV. Provider business mailing address

P.O. BOX 30170
WILMINGTON DE
19805-7170
US

V. Phone/Fax

Practice location:
  • Phone: 302-753-3021
  • Fax:
Mailing address:
  • Phone: 302-623-7200
  • Fax: 302-623-7374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC000944
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP007766
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG0000509
License Number StateDE
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP8274
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberLG0000509
License Number StateDE
# 6
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAC000944
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP007766
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP60683716
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: