Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | L8-0000166 | DE |
NPI | 1013483627 |
---|---|
Provider Name | Michelle Lauer |
First Address | Newark, DE 19713-3468 |
Second Address | Wilmington, DE 19810-4900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2018 |
Last Update Date | 22/10/2018 |