Provider Demographics
NPI:1033892427
Name:WAITHE, GINA BELONESIA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:BELONESIA
Last Name:WAITHE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E ELGIN CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4004
Mailing Address - Country:US
Mailing Address - Phone:302-312-7014
Mailing Address - Fax:
Practice Address - Street 1:2600 GLASGOW AVE STE 100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5703
Practice Address - Country:US
Practice Address - Phone:302-273-1317
Practice Address - Fax:302-273-1581
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN747622163W00000X
MDAC006179363LF0000X
DELG-0012446363LF0000X
DEL1-0041231163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse