Individual
JENNIFER SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
16529 COASTAL HWY, LEWES, DE 19958-3696
(302) 684-2000
Mailing address
16529 COASTAL HWY, LEWES, DE 19958-3696
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0035220
DE
363L00000X
Nurse Practitioner
Primary
LP-0000240
DE
363LP2300X
Primary Care Nurse Practitioner
APN0001844
DE
Other
Enumeration date
01/06/2015
Last updated
03/17/2018
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