Provider Demographics
NPI:1891418901
Name:TOURE, MAKESA A (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MAKESA
Middle Name:A
Last Name:TOURE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 ASHVALE DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4029
Mailing Address - Country:US
Mailing Address - Phone:302-507-3285
Mailing Address - Fax:
Practice Address - Street 1:314 E MAIN STREET
Practice Address - Street 2:STE 403
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7182
Practice Address - Country:US
Practice Address - Phone:302-369-3533
Practice Address - Fax:302-369-3093
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010381363LP0808X
DEL1-0050983163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse