Provider Demographics
NPI:1841579216
Name:SOSANGELIS, MARTHA MICHELE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:MICHELE
Last Name:SOSANGELIS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MISS
Other - First Name:MARTHA
Other - Middle Name:MICHELE
Other - Last Name:SOSANGELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:511 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1449
Mailing Address - Country:US
Mailing Address - Phone:302-577-3521
Mailing Address - Fax:302-577-6594
Practice Address - Street 1:511 W 8TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1449
Practice Address - Country:US
Practice Address - Phone:302-577-3521
Practice Address - Fax:302-577-6594
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH-0000117363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health