MBWIDIFFU A DIBAL (NPI# 1629473483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629473483 |
| Entity Type | Individual |
| Full Name | MBWIDIFFU A DIBAL |
| Other Name | MBWIDIFFU SALMAMZA |
| Credential | NP-C |
| Practice Address |
4001 Miller Rd Ste 1 Wilmington DE 19802-1961 |
| Practice Telephone | 3024075222 |
| Practice Fax Number | 3024075221 |
| Mailing Telephone | 3024075222 |
| Mailing Fax Number | 3024075221 |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2020-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
LG-0000757 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DE | 200141998 | 05 |
| Street Address |
4001 MILLER RD STE 1 |
| City | WILMINGTON |
| State | DE |
| Zip Code | 19802-1961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174951081 | Taylor Ashley Roane Burge | Nurse Practitioner | 4001 Miller Rd Ste 1, Wilmington, DE 19802-1961 | 2013-10-31 |
| 1285191494 | Precision Care & Wellness, LLC | Clinic/Center | 4001 Miller Rd Ste 1, Wilmington, DE 19802-1961 | 2019-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457828352 | Allison Porter Nast | Nurse Practitioner | 1624 N Jessup Street, Wilmington, DE 19802 | 2018-10-29 |
| 1851804694 | Laura Jean Cornelis | Nurse Practitioner | 908b East 16th Street, Wilmington, DE 19802 | 2017-11-15 |
| 1477094365 | Jennifer Burris | Nurse Practitioner | 908-b East 16th Street, Wilmington, DE 19802 | 2017-03-13 |
| 1245694694 | Rochelle L Johnson | Counselor | 2005 Baynard Boulevard, Wilmington, DE 19802 | 2016-04-12 |
| 1942674692 | Barbara G Goldsmith | Social Worker | 501 W 37th St, Wilmington, DE 19802 | 2015-11-18 |
| 1942590492 | Olalekan David Falade | Pharmacist | 602 C4 West Lea Blvd, Wilmington, DE 19802 | 2011-04-18 |
| 1598919144 | Trina Brooks Haywood | Registered Nurse | 700 W Lea Blvd Ste 201, Wilmington, DE 19802 | 2008-11-10 |
| 1184808347 | Dr Lesly Robinson Dpm | Podiatrist | 4011 N Market Street, Wilmington, DE 19802 | 2007-12-24 |
| 1366622110 | Overbrook Therapy Associates | Community/Behavioral Health | 1015 West 24th Street, Wilmington, DE 19802 | 2007-11-09 |
| 1215059332 | Everett T Dickerson | Counselor | 620 W 27th St, Wilmington, DE 19802 | 2007-04-06 |
| Find all providers in zip 19802 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488428 | Samantha Kuhlman | Nurse Practitioner | 1509 Doctors Cir Bldg C, Wilmington, NC 28401-7403 | 2020-08-21 |
| 1023630290 | Carole King Stevenson | Nurse Practitioner | 1111 Figueroa Pl # Tech115, Wilmington, CA 90744-2311 | 2020-05-11 |
| 1962031039 | Jasmine Marie Locklear | Nurse Practitioner | 2550 41st St, Wilmington, NC 28403-5519 | 2020-04-02 |
| 1811558422 | Emma Rose Boisvert I | Nurse Practitioner | Deerfield Valley Health Center, 30 Route 100 South, Wilmington, VT 05363-0536 | 2019-06-25 |
| 1922569482 | Joy Peterson | Nurse Practitioner | 1815 W 13th St Ste 1, Wilmington, DE 19806-4054 | 2019-03-27 |
| 1104382308 | Caitlin Gallagher | Nurse Practitioner | 608 Dawson St Ste 103, Wilmington, NC 28401-5712 | 2019-02-13 |
| 1407344476 | Adelle Grant-mcauley | Nurse Practitioner | 3521 Silverside Rd., Quillen Building Suite 2j, Wilmington, DE 19810 | 2018-04-25 |
| 1538674767 | Angela M Mcnulty | Nurse Practitioner | 3521 Silverside Rd Ste 1c, Wilmington, DE 19810-4900 | 2017-12-11 |
| 1851804694 | Laura Jean Cornelis | Nurse Practitioner | 908b East 16th Street, Wilmington, DE 19802 | 2017-11-15 |
| 1952825168 | Alicia Camille Vogleson | Nurse Practitioner | 2601 Annand Dr Ste 3, Wilmington, DE 19808-3719 | 2017-07-29 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 19802 |
Please comment or provide details below to improve the information on MBWIDIFFU A DIBAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.