Healthcare Provider Details

I. General information

NPI: 1801733225
Provider Name (Legal Business Name): MICHELLE TIFFANY MCMANUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE TIFFANY HOLDEN

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 S MAIN ST
SMYRNA DE
19977-1410
US

IV. Provider business mailing address

198 S MAIN ST
SMYRNA DE
19977-1410
US

V. Phone/Fax

Practice location:
  • Phone: 302-293-0286
  • Fax:
Mailing address:
  • Phone: 302-293-0286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: