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General NPI Number Information
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NPI Number | 1427868447
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Entity Type | Individual
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Provider Name | ANNETTE REGINA MANSON CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 21635 BIDEN AVE UNIT 101
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City | GEORGETOWN
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State | DE
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Zip | 19947-4575
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Country | US
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Telephone | 302-856-9596
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Fax | 302-645-4744
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Provider Business Mailing Address
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Address Line | 1515 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1675
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Country | US
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Telephone | 302-645-3499
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Fax | 302-644-4830
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0013085
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0013085
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License Number State | DE
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