Individual
KRISTI MAIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN STANTON RD, SUITE 1E50, NEWARK, DE 19718-0001
(302) 733-1980
(302) 733-1987
Mailing address
4755 OGLETOWN STANTON RD, SUITE 1E50, NEWARK, DE 19718-0001
(302) 733-1980
(302) 733-1987
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0000502
DE
363AS0400X
Surgical Physician Assistant
C5-0000502
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5-0000502
PROFESSIONAL LICENSE
DE
Enumeration date
12/05/2006
Last updated
03/12/2013
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