Healthcare Provider Details

I. General information

NPI: 1083048748
Provider Name (Legal Business Name): FLORENCE AKOUEGNON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 12/05/2021
Certification Date: 12/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5223 W WOODMILL DR STE 41
WILMINGTON DE
19808-4068
US

IV. Provider business mailing address

5223 W WOODMILL DR STE 41
WILMINGTON DE
19808-4068
US

V. Phone/Fax

Practice location:
  • Phone: 302-516-7936
  • Fax: 302-510-6964
Mailing address:
  • Phone: 302-516-7936
  • Fax: 302-510-6964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberLP-000135
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberLP-000135
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberLP-00013
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberLP-000135
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLP-00013
License Number StateDE
# 6
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLP-000135
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: