Healthcare Provider Details

I. General information

NPI: 1376409250
Provider Name (Legal Business Name): TAMIRA HARGROW MSN,RN,APRN,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5163 W WOODMILL DR STE 13
WILMINGTON DE
19808-4067
US

IV. Provider business mailing address

5163 W WOODMILL DR STE 13
WILMINGTON DE
19808-4067
US

V. Phone/Fax

Practice location:
  • Phone: 302-660-7200
  • Fax: 302-543-5644
Mailing address:
  • Phone: 302-660-7200
  • Fax: 302-543-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0011009
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: