Active NPI
Ete Kwegang
- Psychiatric/Mental Health Nurse Practitioner
- Middletown, DE
National Provider Identifier
1194306209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R204709
- Practice address
- 108 Patriot Dr Ste a
Middletown, DE 19709-8803 - Phone
- (240) 701-7300
- NPI assigned
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R204709 | MD | Primary |
Addresses
Primary practice location
108 Patriot Dr Ste a
Middletown, DE 19709-8803
Mailing address
108 Patriot Dr Ste a
Middletown, DE 19709-8803
Phone (240) 701-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R204709 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715299200000",
"number": "1194306209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 PATRIOT DR STE A",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197098803",
"telephone_number": "240-701-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 PATRIOT DR STE A",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197098803",
"telephone_number": "240-701-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWEGANG",
"first_name": "ETE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2024-05-10",
"certification_date": "2024-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R204709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.