Healthcare Provider Details

I. General information

NPI: 1841350485
Provider Name (Legal Business Name): NOEL EILEEN MEDEIROS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5352 LINTON BLVD STE 100
DELRAY BEACH FL
33484-6514
US

IV. Provider business mailing address

1 FEDERAL ST STE SW200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-9140
  • Fax: 561-404-5035
Mailing address:
  • Phone: 856-356-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11005757
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP009271
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11005757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: