Healthcare Provider Details

I. General information

NPI: 1538476577
Provider Name (Legal Business Name): MERIAM LORAINE DENNIE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 09/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-0001
US

IV. Provider business mailing address

800 SALEM CHURCH RD
NEWARK DE
19702-4040
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-6675
  • Fax: 302-733-6367
Mailing address:
  • Phone: 302-547-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberL9-0000108
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: