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General NPI Number Information
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NPI Number | 1366107393
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Entity Type | Individual
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Provider Name | TAMICA NICHOLE D'AGUIAR CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 800 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6192
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Country | US
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Telephone | 215-829-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 501 SILVERSIDE RD STE 61
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City | WILMINGTON
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State | DE
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Zip | 19809-1394
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Country | US
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Telephone | 302-824-1002
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Fax |
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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 | SP024078
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License Number State | PA
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