Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | LM-0000111 | DE |
NPI | 1114142338 |
---|---|
Provider Name | Theresa Marie Mcgreevy |
First Address | Newark, DE 19702-3645 |
Second Address | Newark, DE 19718-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2007 |
Last Update Date | 08/07/2007 |