Individual
KIMBERLY WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
4735 OGLETOWN STANTON RD, MEDICAL ARTS PAVILION 2, SUITE 3301, NEWARK, DE 19713-2072
(302) 623-4370
(302) 623-4375
Mailing address
200 HYGEIA DR, SUITE 2300, NEWARK, DE 19713-2049
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
LP-0000194
DE
363LA2200X
Adult Health Nurse Practitioner
LP-0000194
DE
363LG0600X
Gerontology Nurse Practitioner
LP-0000194
DE
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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