Individual
KEVIN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
640 S STATE ST, DOVER, DE 19901-3530
(302) 744-7122
Mailing address
20 NOMAD TRL, CAMDEN, DE 19934-4222
(856) 466-0541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
LG-0001099
DE
363LF0000X
Family Nurse Practitioner
Primary
LG-0001099
DE
Other
Enumeration date
12/15/2017
Last updated
08/30/2024
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