Healthcare Provider Details

I. General information

NPI: 1700926243
Provider Name (Legal Business Name): ROBERT B NOWELL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 LIMESTONE RD SUITE #5
WILMINGTON DE
19808-5553
US

IV. Provider business mailing address

2006 LIMESTONE RD SUITE #5
WILMINGTON DE
19808-5553
US

V. Phone/Fax

Practice location:
  • Phone: 302-995-1860
  • Fax: 302-995-5421
Mailing address:
  • Phone: 302-995-1860
  • Fax: 302-995-5421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL6-0A00020
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: