Provider Demographics
NPI:1093980591
Name:CORRADETTI, RENEE L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:L
Last Name:CORRADETTI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 FOULK RD STE F
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3700
Mailing Address - Country:US
Mailing Address - Phone:302-529-2255
Mailing Address - Fax:302-529-2257
Practice Address - Street 1:1805 FOULK RD STE F
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3700
Practice Address - Country:US
Practice Address - Phone:302-529-2255
Practice Address - Fax:302-529-2257
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000305363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily