Provider Demographics
NPI:1659372670
Name:DELAWARE FAMILY HEALTHCARE ALLIANCE
Entity Type:Organization
Organization Name:DELAWARE FAMILY HEALTHCARE ALLIANCE
Other - Org Name:FAMILY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADVANCED PRACTICE NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:NMI
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:302-677-0515
Mailing Address - Street 1:136 TRAYBERN BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1947
Mailing Address - Country:US
Mailing Address - Phone:302-677-0515
Mailing Address - Fax:302-677-0415
Practice Address - Street 1:1675 S DUPONT HWY
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-5129
Practice Address - Country:US
Practice Address - Phone:302-677-0515
Practice Address - Fax:302-677-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH000159363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty