Healthcare Provider Details

I. General information

NPI: 1316668049
Provider Name (Legal Business Name): DAWN TERIE PLOUCHER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 E GLENWOOD AVE # 295
SMYRNA DE
19977-1002
US

IV. Provider business mailing address

139 E PEMBROOKE DR
SMYRNA DE
19977-4006
US

V. Phone/Fax

Practice location:
  • Phone: 302-513-1913
  • Fax:
Mailing address:
  • Phone: 302-494-9846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC005299
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number838533
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP026396
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010356
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: