Provider Demographics
NPI:1316403991
Name:PATEL, AVANIBEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:AVANIBEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W 4TH ST STE 9
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3367
Mailing Address - Country:US
Mailing Address - Phone:302-356-0506
Mailing Address - Fax:302-486-3400
Practice Address - Street 1:2500 W 4TH ST STE 9
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3367
Practice Address - Country:US
Practice Address - Phone:302-356-0506
Practice Address - Fax:302-486-3400
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704256046363LF0000X
DELG-0001284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily