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NPI Code Detail

MEDICARE: JANELLE AGNEW APRN, PMHNP-BC

MEDICARE: JANELLE AGNEW APRN, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner66255ID
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAC002405MD
3363LP0808XPsychiatric/Mental Health Nurse PractitionerSP023449PA
4363LP0808XPsychiatric/Mental Health Nurse PractitionerL8-0000162DE

General Provider Information

NPI Number : 1215415880
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE AGNEW APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 600 N. BROAD STREET
Second Line : SUITE 5 #3577
City : MIDDLETOWN
State : DE
Zip : 19709
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 DELAWARE AVE STE 1205
Second Line :
City : WILMINGTON
State : DE
Zip : 19801-1670
Country : US
Telephone Number : 617-379-0496
Fax Number : 617-864-0614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2018
Last Update Date : 03/23/2023

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