Healthcare Provider Details
I. General information
NPI: 1801876578
Provider Name (Legal Business Name): DANIELLE JEROME RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/19/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
232 STEEPLECHASE CIR
WILMINGTON DE
19808-1977
US
IV. Provider business mailing address
232 STEEPLECHASE CIR
WILMINGTON DE
19808-1977
US
V. Phone/Fax
- Phone: 302-598-3900
- Fax:
- Phone: 302-598-3900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | DN-0011214 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: