Healthcare Provider Details

I. General information

NPI: 1073343539
Provider Name (Legal Business Name): RACHEL ANNE MCCABE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 OGLETOWN STANTON RD STE 106
NEWARK DE
19713-2070
US

IV. Provider business mailing address

618 ASHFORD RD
WILMINGTON DE
19803-2406
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-9800
  • Fax:
Mailing address:
  • Phone: 302-388-8728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberLH-0010290
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: