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

LicenseStateTypeSpecialty
L1-004321ODEMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Georgetown, DE

All providers in Georgetown, DE · School Registered Nurse in Delaware

Sources for this page

Verify at the official NPI Registry.