Provider Demographics
NPI:1396821930
Name:NOVELLO, VICTORIA L (CRNA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:NOVELLO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:L
Other - Last Name:LEWIS AND NEPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:640 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-744-7088
Mailing Address - Fax:
Practice Address - Street 1:111 CONTINENTAL DR
Practice Address - Street 2:SUITE 412
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4306
Practice Address - Country:US
Practice Address - Phone:302-709-4497
Practice Address - Fax:302-733-0854
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0029498367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered