Healthcare Provider Details

I. General information

NPI: 1184134801
Provider Name (Legal Business Name): SERAH W. MUHORO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2017
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MILLTOWN RD STE 2
WILMINGTON DE
19808-4047
US

IV. Provider business mailing address

745 STAGHORN DR
NEW CASTLE DE
19720-7655
US

V. Phone/Fax

Practice location:
  • Phone: 302-230-1665
  • Fax:
Mailing address:
  • Phone: 302-230-1665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0035695
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0001067
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: