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General NPI Number Information
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NPI Number | 1811878770
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Entity Type | Individual
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Provider Name | TAILISHA MCNAIR
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Gender | Female
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 5175 W WOODMILL DR # 7
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City | WILMINGTON
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State | DE
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Zip | 19808-4067
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Country | US
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Telephone | 302-999-8426
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Fax |
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Provider Business Mailing Address
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Address Line | 73 GREENTREE DR # 307
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City | DOVER
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State | DE
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Zip | 19904-7646
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Country | US
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Telephone | 302-399-5001
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0010728
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License Number State | DE
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