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General NPI Number Information
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NPI Number | 1952088668
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Entity Type | Individual
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Provider Name | SVETLANA ALEKSANDROVNA AGAPOV A-GNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/04/2023
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Last Update Date | 07/04/2023
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Provider Practice Location Address
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Address Line | 16295 WILLOW CREEK RD
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City | LEWES
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State | DE
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Zip | 19958-3614
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Country | US
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Telephone | 302-644-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MORGANS TURN
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City | OCEAN VIEW
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State | DE
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Zip | 19970-3144
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Country | US
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Telephone | 443-856-8699
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | LP-0010654.
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License Number State | DE
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