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Individual

MR. JEAN J PANTAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
1500 SHALLCROSS AVE STE 1A, WILMINGTON, DE 19806-3037
(302) 200-5080
Mailing address
1500 SHALLCROSS AVE, WILMINGTON, DE 19806-3037
(302) 200-5080

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP010360
PA
363LA2200X
Adult Health Nurse Practitioner
SP010360
PA
363LC1500X
Community Health Nurse Practitioner
SP010360
PA
363LG0600X
Gerontology Nurse Practitioner
SP010360
PA

Other

Enumeration date
08/14/2009
Last updated
04/20/2023
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