NPIMap

Susan Carol Porth, APN

Individual provider Active NPI Nurse Practitioner · Wilmington, DE

NPI 1083678890 · NPPES record last updated Jan 4, 2013

Key facts

NPI
1083678890
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
L1-0024916 (DE)
Practice address
1600 Rockland Rd
Ai Dupont Hospital for Children
Wilmington, DE 19803-3607
Phone
(302) 651-4200
Fax
(302) 651-5948
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L1-0024916DEMDNurse Practitioner
UP0036450PAMDNurse Practitioner
UP003645OPAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X UP003645O PA
Nurse Practitioner 363L00000X L1-0024916 DE Yes
Nurse Practitioner 363L00000X UP0036450 PA

Addresses

Primary practice location

1600 Rockland Rd
Ai Dupont Hospital for Children
Wilmington, DE 19803-3607

Mailing address

PO Box 191
Provider Enrollment
Rockland, DE 19732-0191
Phone (302) 651-4000

Other providers in Wilmington, DE

All providers in Wilmington, DE · Nurse Practitioner in Delaware

Sources for this page

Verify at the official NPI Registry.