Individual
MR. KEITH FRANK FISHLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1600 ROCKLAND ROAD, WILMINGTON, DE 19803-3607
(302) 651-4200
(302) 651-5365
Mailing address
P.O. BOX 191, ROCKLAND, DE 19723-0191
(302) 651-4000
(602) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
L10028008
DE
364SP0200X
Pediatric Clinical Nurse Specialist
LW-0000123
DE
Other
Enumeration date
05/11/2010
Last updated
09/16/2011
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