Provider Demographics
NPI:1942277553
Name:ARCHBALD, ANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:ARCHBALD
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 1:5311 LIMESTONE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1246
Mailing Address - Country:US
Mailing Address - Phone:302-234-9109
Mailing Address - Fax:302-234-9042
Practice Address - Street 1:5311 LIMESTONE RD
Practice Address - Street 2:STE 201
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1246
Practice Address - Country:US
Practice Address - Phone:302-234-9109
Practice Address - Fax:302-234-9042
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000184363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
011968S36Medicare ID - Type Unspecified
P91332Medicare UPIN