Provider Demographics
NPI:1730519372
Name:AMOROSO, SHANNA MARIE (ACNP)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:MARIE
Last Name:AMOROSO
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:
Other - Last Name:GOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4755 OGLETOWN STANTON RD STE 2E99
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-733-5982
Mailing Address - Fax:302-733-6081
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 2E99
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-5982
Practice Address - Fax:302-733-6081
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197392163W00000X
DELP-0000310363L00000X, 363LA2100X
SC18929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner