=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417322447
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEAN MARIE TUETE ACNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2015
-----------------------------------------------------
Last Update Date | 02/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5641 DUPONT PKWY
-----------------------------------------------------
City | SMYRNA
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19977-9229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-389-8443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5641 DUPONT PKWY
-----------------------------------------------------
City | SMYRNA
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19977-9229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-389-8443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | L8-0010551
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ00622900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN655557
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | LP0000202
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | LP0000202
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------