Provider Demographics
NPI:1144683152
Name:KOHL, DAVID ALAN (FNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:KOHL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 FOULK RD
Mailing Address - Street 2:SUITE 200 B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3820
Mailing Address - Country:US
Mailing Address - Phone:302-762-6675
Mailing Address - Fax:302-762-6695
Practice Address - Street 1:410 FOULK RD
Practice Address - Street 2:SUITE 200 B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3820
Practice Address - Country:US
Practice Address - Phone:302-762-6675
Practice Address - Fax:302-762-6695
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily