Provider Demographics
NPI:1558009779
Name:PIPER, THERESA A (MSN, CNM)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:PIPER
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1544
Mailing Address - Country:US
Mailing Address - Phone:302-242-4611
Mailing Address - Fax:
Practice Address - Street 1:101 WELLNESS WAY STE 300
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4366
Practice Address - Country:US
Practice Address - Phone:302-424-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELK-0010220367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife