Healthcare Provider Details

I. General information

NPI: 1780704460
Provider Name (Legal Business Name): NICOLE LIMMINA SCOTT N.P.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 FOULK RD STE 200B
WILMINGTON DE
19803-3802
US

IV. Provider business mailing address

410 FOULK RD STE 200B
WILMINGTON DE
19803-3802
US

V. Phone/Fax

Practice location:
  • Phone: 302-762-6692
  • Fax:
Mailing address:
  • Phone: 302-762-6692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0028541
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberLB-0000198
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: