Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | LP-0000146 | DE |
NPI | 1033570635 |
---|---|
Provider Name | Naomi Stewart Durham |
First Address | New Castle, DE 19720-1649 |
Second Address | New Castle, DE 19720-1649 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2016 |
Last Update Date | 10/03/2016 |