Basic Information
| Provider Information | |||||||||
| NPI: | 1770747651 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | LU | ||||||||
| FirstName: | SA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 252 CHAPMAN RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197025436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023667665 | ||||||||
| FaxNumber: | 3023660734 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 N CLAYTON ST | ||||||||
| Address2: | SUITE 407 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198053165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023667665 | ||||||||
| FaxNumber: | 3023660734 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2008 | ||||||||
| LastUpdateDate: | 07/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | LG0000466 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.