Healthcare Provider Details

I. General information

NPI: 1780861427
Provider Name (Legal Business Name): ELLEN KEMUNTO MOCHACHE SOIRE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S COLLEGE AVE STE 130
NEWARK DE
19713-1302
US

IV. Provider business mailing address

540 S COLLEGE AVE STE 130
NEWARK DE
19713-1302
US

V. Phone/Fax

Practice location:
  • Phone: 302-831-3000
  • Fax: 302-831-3193
Mailing address:
  • Phone: 302-831-3000
  • Fax: 302-831-3193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 17815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: