Individual provider Active NPI

Nancy Mamouzal

  • Licensed Practical Nurse
  • Middletown, DE
National Provider Identifier
1528846003
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L2-0024350 Issued in DE
Practice address
180 Liborio Dr
Middletown, DE 19709-3104
Phone
(302) 419-6533
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L2-0024350 DE Primary

Addresses

Primary practice location

180 Liborio Dr
Middletown, DE 19709-3104

Mailing address

314 Grove Neck Rd
Earleville, MD 21919-3008
Phone (410) 275-6200

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L2-0024350DEMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1528846003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 GROVE NECK RD",
            "city": "EARLEVILLE",
            "state": "MD",
            "postal_code": "219193008",
            "telephone_number": "410-275-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 LIBORIO DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197093104",
            "telephone_number": "302-419-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMOUZAL",
        "first_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DE",
            "license": "L2-0024350",
            "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 Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.