Individual
ANISSA NURSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 N DUPONT HWY, NEW CASTLE, DE 19720-1100
(302) 255-2700
Mailing address
1901 N DUPONT HWY, NEW CASTLE, DE 19720-1100
(302) 255-2700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0001362
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J2-0001362
LICENSE NUMBER
DE
Enumeration date
09/30/2019
Last updated
09/30/2019
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