Healthcare Provider Details

I. General information

NPI: 1528875473
Provider Name (Legal Business Name): HAILEE ELIZABETH MONIES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 W 4TH ST
WILMINGTON DE
19805-3420
US

IV. Provider business mailing address

PO BOX 151
NEW CASTLE DE
19720-0151
US

V. Phone/Fax

Practice location:
  • Phone: 302-655-5822
  • Fax: 302-322-6201
Mailing address:
  • Phone: 302-652-2455
  • Fax: 302-322-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012454
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: