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General NPI Number Information
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NPI Number | 1851002000
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Entity Type | Organization
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Legal Business Name | HEALTHVITALS,LLC
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 802 N WEST ST
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City | WILMINGTON
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State | DE
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Zip | 19801-1526
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Country | US
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Telephone | 302-407-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 205 CHRISTINA LANDING DR
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City | WILMINGTON
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State | DE
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Zip | 19801-5248
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Country | US
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Telephone | 302-407-5155
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Fax |
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Authorized Official
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Title or Position | CHIEF PHYSICIAN EXECUTIVE
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Name | NKIRUKA SANDRA NNEBE
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Credential | MD
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Telephone | 302-407-5155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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