Individual
ELIZABETH JEAN WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
BUILDING B-86, OMEGA DR, NEWARK, DE 19713-6004
(302) 366-7665
(302) 366-0734
Mailing address
252 CHAPMAN RD, SUITE 150, NEWARK, DE 19702-5438
(302) 623-1929
(302) 366-1075
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
LB0000230
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659600039
—
DE
01
—
LB0000230
DE PROFESSIONAL LICENSE
DE
Enumeration date
12/15/2009
Last updated
11/08/2016
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