Healthcare Provider Details

I. General information

NPI: 1053597724
Provider Name (Legal Business Name): VICTORIA LYNN LEPORE CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2008
Last Update Date: 01/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 KIRKWOOD HWY STE 203
WILMINGTON DE
19808-4884
US

IV. Provider business mailing address

16840 HENDERSON RD LOT 159
HENDERSON MD
21640-1664
US

V. Phone/Fax

Practice location:
  • Phone: 302-998-0469
  • Fax: 302-998-0298
Mailing address:
  • Phone: 410-482-2860
  • Fax: 410-482-2860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberDE00009901105
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: