Provider Demographics
NPI:1700509296
Name:BYRNES, THOMAS J IV (FNP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:BYRNES
Suffix:IV
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 CARTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5845
Mailing Address - Country:US
Mailing Address - Phone:844-365-7246
Mailing Address - Fax:844-516-0080
Practice Address - Street 1:405 SILVERSIDE RD STE 104
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1768
Practice Address - Country:US
Practice Address - Phone:844-365-7246
Practice Address - Fax:844-516-0080
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEL1-0036577163W00000X
DELG-0012102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse