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General NPI Number Information
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NPI Number | 1851071161
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Entity Type | Individual
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Provider Name | KATRESE L THOMAS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 08/06/2023
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Provider Practice Location Address
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Address Line | 240 N JAMES ST STE 200
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City | WILMINGTON
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State | DE
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Zip | 19804-3171
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Country | US
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Telephone | 302-543-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 500 E HANNA DR
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City | NEWARK
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State | DE
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Zip | 19702-2702
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Country | US
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Telephone | 302-983-1279
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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 | L8-0010475
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License Number State | DE
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