Healthcare Provider Details

I. General information

NPI: 1215415880
Provider Name (Legal Business Name): JANELLE AGNEW APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 LIBRARY AVE STE 100
NEWARK DE
19711-7170
US

IV. Provider business mailing address

850 LIBRARY AVE STE 100
NEWARK DE
19711-7170
US

V. Phone/Fax

Practice location:
  • Phone: 302-319-5161
  • Fax:
Mailing address:
  • Phone: 302-319-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC002405
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number66255
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP023449
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0000162
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: