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General NPI Number Information
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NPI Number | 1174358352
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Entity Type | Organization
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Legal Business Name | DE TRINITY PM HEALTH
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 2300 PENNSYLVANIA AVE STE 3B
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City | WILMINGTON
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State | DE
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Zip | 19806-1333
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Country | US
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Telephone | 302-339-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 PENNSYLVANIA AVE STE 3B
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City | WILMINGTON
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State | DE
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Zip | 19806-1333
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Country | US
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Telephone | 302-339-2260
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Fax |
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Authorized Official
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Title or Position | FNP, PMHNP
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Name | MRS. ADEBOLA RITA USUAH
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Credential | NP
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Telephone | 302-339-2260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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