Healthcare Provider Details

I. General information

NPI: 1306776653
Provider Name (Legal Business Name): NISHELLE DENISE HARRIS-HINES DNP,MSN,APRN,PMHNP-B
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NISHELLE DENISE HARRIS-HINES DNP,MSN,PMHNP-BC

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 WEDGE CT
TOWNSEND DE
19734-2843
US

IV. Provider business mailing address

117 WEDGE CT
TOWNSEND DE
19734-2843
US

V. Phone/Fax

Practice location:
  • Phone: 215-828-0464
  • Fax: 302-832-8198
Mailing address:
  • Phone: 215-828-0464
  • Fax: 302-832-8198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2026000918
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: