Provider Demographics
NPI:1982369369
Name:BROWN-ADEKUNLE, STACEY RENEE (WHNP)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:RENEE
Last Name:BROWN-ADEKUNLE
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4060
Mailing Address - Country:US
Mailing Address - Phone:302-399-6610
Mailing Address - Fax:302-399-6610
Practice Address - Street 1:100 S MAIN ST STE 215
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1479
Practice Address - Country:US
Practice Address - Phone:302-659-4520
Practice Address - Fax:302-659-4525
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0031632163WX0003X
DELH-0010282367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient