Provider Demographics
NPI:1447204698
Name:POMILLA, ROSEMARIE (NP)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:POMILLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SAVANNAH RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1499
Mailing Address - Country:US
Mailing Address - Phone:302-645-3555
Mailing Address - Fax:302-644-3560
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1462
Practice Address - Country:US
Practice Address - Phone:302-645-3555
Practice Address - Fax:302-644-3560
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELM-0000135363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000040447Medicaid
DE1447204698OtherDE PHYSICIAN CARE MCAID
DE19598B86OtherRAILROAD MEDICARE
DE522011HOSOtherBCBS OF DE -HOSPITALIST
DE1000040447OtherDIAMOND STATE MEDICAID
DE595620OtherCOVENTRY HEALTH CARE
DE00000020738OtherUNISON HEALTH CARE-MCAID
DE019598B86Medicare PIN
DE1000040447OtherDIAMOND STATE MEDICAID