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General NPI Number Information
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NPI Number | 1538010640
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Entity Type | Individual
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Provider Name | TERESIA KYUSEE KISESEWA
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Gender | Female
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 2100 BAYNARD BLVD
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City | WILMINGTON
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State | DE
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Zip | 19802-3900
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Country | US
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Telephone | 302-394-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 109 N HUNTER FORGE RD
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City | NEWARK
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State | DE
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Zip | 19713-1108
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Country | US
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Telephone | 302-722-3047
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | LG-0013273
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License Number State | DE
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