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General NPI Number Information
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NPI Number | 1184115354
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Entity Type | Individual
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Provider Name | MONICA SAM FNP
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Gender | Female
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 2006 LIMESTONE RD STE 7
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City | WILMINGTON
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State | DE
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Zip | 19808
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Country | US
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Telephone | 302-355-2383
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Fax | 302-351-6261
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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 | 302-596-8999
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Fax | 302-596-8998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0001069
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License Number State | DE
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