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General NPI Number Information
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NPI Number | 1578296984
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Entity Type | Individual
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Provider Name | JACQUELINE W MWANGI FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/03/2022
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 121 BECKS WOODS DR STE 200
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City | BEAR
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State | DE
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Zip | 19701-3852
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Country | US
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Telephone | 302-834-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 5 BROOKLAND AVE
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City | WILMINGTON
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State | DE
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Zip | 19805-1109
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Country | US
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Telephone | 434-227-8979
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | L1-0044515
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC004595
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0012090
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License Number State | DE
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