Jacqueline Bois
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Middletown, DE
NPI 1972153500 · NPPES record last updated Jul 12, 2024
Key facts
- NPI
- 1972153500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- L8-0010333 (DE)
- Practice address
- 627 Swansea Dr
Middletown, DE 19709-0202 - Phone
- (484) 320-0167
- Fax
- (610) 793-3649
- NPI assigned
- Sep 16, 2019
- 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 |
|---|---|---|---|
| L1-0053019 | DE | MD | Psychiatric/Mental Health Registered Nurse |
| RN533833 | PA | MD | Psychiatric/Mental Health Registered Nurse |
| L8-0010333 | DE | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | L1-0053019 | DE | |
| Psychiatric/Mental Health Registered Nurse |
163WP0808X | RN533833 | PA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | L8-0010333 | DE | Yes |
Addresses
Primary practice location
627 Swansea Dr
Middletown, DE 19709-0202
Mailing address
1901 Brintons Bridge Rd
West Chester, PA 19382-7088
Phone (610) 793-3310
Other providers in Middletown, DE
- Kizzy M Blackwell
- Wanda Siena Blanco
- Blessings of Hope Sober Living
- Alyana Blythe
- Penina Bogita
- Florence K Bona
- Erin Debra Booker
- Kristina Renee Borcky
- Emma Rae Boyd
- BPD Partners LLC
All providers in Middletown, DE · Psychiatric/Mental Health Nurse Practitioner in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2024. 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.