Healthcare Provider Details

I. General information

NPI: 1174066351
Provider Name (Legal Business Name): DARLENE POWELL-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 BRANDYWINE BLVD
WILMINGTON DE
19809-2306
US

IV. Provider business mailing address

1311 BRANDYWINE BLVD
WILMINGTON DE
19809-2306
US

V. Phone/Fax

Practice location:
  • Phone: 302-793-5072
  • Fax: 302-765-1996
Mailing address:
  • Phone: 302-793-5072
  • Fax: 302-765-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberL1-0012847
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: