Doctor Name: | MICHELLE L LEITE |
NPI Number: | 1033100748 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | LG0000289 |
Business Practice Address: | 200 Banning St Suite 170 Dover, DE - 199043485 |
Business Phone Number: | 3026741999 |
Business Fax Number: | |
Mailing Address: | 73 Pear Blossom Ln, CAMDEN |
State: | DE |
Postal Code: | 199344911 |
Phone Number: | 3026979302 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2005 |
NPI Last Update Date: | 02/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | LG0000289 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |