=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659878387
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEIRU ZHAO FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2018
-----------------------------------------------------
Last Update Date | 03/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2400 PHILADELPHIA PIKE
-----------------------------------------------------
City | CLAYMONT
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19703-2431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-317-1531
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 312 S HENDERSON RD
-----------------------------------------------------
City | KING OF PRUSSIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19406-2408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-205-1264
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | L1-0053872
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | LG-0001259
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP018513
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | LG-0001259
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------