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Individual

MR. DALLAS L MASTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC FNP-C

Contact information

Practice address
100 WELLNESS WAY, MILFORD, DE 19963-4364
(302) 943-3637
Mailing address
100 WELLNESS WAY, MILFORD, DE 19963-4364
(302) 943-3637

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0043517
DE
363LF0000X
Family Nurse Practitioner
Primary
LG-0011570
DE

Other

Enumeration date
01/06/2021
Last updated
08/09/2021
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