Provider Demographics
NPI:1396224895
Name:ADWA, ELIZABETH A (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:ADWA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3309
Mailing Address - Country:US
Mailing Address - Phone:302-655-9624
Mailing Address - Fax:
Practice Address - Street 1:50 JAMES BUCHANAN RD
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1132
Practice Address - Country:US
Practice Address - Phone:610-200-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0038249163W00000X
PARN606784163W00000X
DEL8-0010246363LP0808X
PASP019191363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse