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NPI Code Detail

MEDICARE: FATIMAH K BOONE PMHNP-BC

MEDICARE: FATIMAH K BOONE 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 PractitionerAC007451MD
2363LP0808XPsychiatric/Mental Health Nurse Practitioner405323NY
3163W00000XRegistered Nurse817880NY
4363LP0808XPsychiatric/Mental Health Nurse PractitionerL8-0010388DE

General Provider Information

NPI Number : 1629793807
Entity Type Code : Individual
Provider Name (Legal Business Name) : FATIMAH K BOONE PMHNP-BC
Provider Business Mailing Address
First Line : 501 W 14TH ST STE 1E40
Second Line :
City : WILMINGTON
State : DE
Zip : 19801-1013
Country : US
Telephone Number : 302-320-2100
Fax Number : 302-320-2121
Provider Business Practice Location Address
First Line : 501 W 14TH ST STE 1E40
Second Line :
City : WILMINGTON
State : DE
Zip : 19801-1013
Country : US
Telephone Number : 302-320-2100
Fax Number : 302-320-2121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 06/17/2026

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