Healthcare Provider Details

I. General information

NPI: 1437547668
Provider Name (Legal Business Name): STEPHANIE A EVANS-MITCHELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2014
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WEST 14TH STREET 3RD FLOOR
WILMINGTON DE
19801-1012
US

IV. Provider business mailing address

200 HYGEIA DRIVE SUITE 2300
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-320-2100
  • Fax:
Mailing address:
  • Phone: 302-312-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0000781
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: