Individual
SAIDA MOUOTASSIM ELIDRISSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
(302) 733-5640
Mailing address
41 MONTAGUE RD, NEWARK, DE 19713-1153
(302) 528-6776
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0067141
DE
363L00000X
Nurse Practitioner
LP-0010864
DE
363LA2100X
Acute Care Nurse Practitioner
Primary
LP-0010864
DE
363LA2200X
Adult Health Nurse Practitioner
LP-0010864
DE
363LG0600X
Gerontology Nurse Practitioner
LP-0010864
DE
Other
Enumeration date
07/02/2025
Last updated
10/01/2025
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