Healthcare Provider Details

I. General information

NPI: 1285560086
Provider Name (Legal Business Name): TANYA J SMOLLEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 LIMESTONE RD STE 211
WILMINGTON DE
19808-5400
US

IV. Provider business mailing address

1941 LIMESTONE RD STE 211
WILMINGTON DE
19808-5400
US

V. Phone/Fax

Practice location:
  • Phone: 302-534-8100
  • Fax: 302-543-8905
Mailing address:
  • Phone: 302-534-8100
  • Fax: 302-543-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLP-0011074
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: