Healthcare Provider Details

I. General information

NPI: 1013483627
Provider Name (Legal Business Name): MICHELLE LAUER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 FOULK RD STE 102
WILMINGTON DE
19803-3835
US

IV. Provider business mailing address

410 FOULK RD STE 102
WILMINGTON DE
19803-3835
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-6199
  • Fax: 302-384-7162
Mailing address:
  • Phone: 302-478-6199
  • Fax: 302-384-7162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0000166
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: