Susan Dattilo
Individual provider Active NPI School Registered Nurse · Georgetown, DE
NPI 1548877293 · NPPES record last updated Sep 28, 2020
Key facts
- NPI
- 1548877293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- L1-004321O (DE)
- Practice address
- 22051 Wilson Rd
Georgetown, DE 19947-3770 - Phone
- (302) 856-3300
- NPI assigned
- Sep 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1-004321O | DE | MD | School Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | L1-004321O | DE | Yes |
Addresses
Primary practice location
22051 Wilson Rd
Georgetown, DE 19947-3770
Mailing address
22051 Wilson Rd
Georgetown, DE 19947-3770
Phone (302) 856-3300
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All providers in Georgetown, DE · School Registered Nurse in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.