NPI 1275160566 · live from the CMS NPI Registry
Jerise Atock Agha, NP
Nurse Practitioner, Gerontology in Middletown, DE. National Provider Identifier 1275160566, active.
NPI record
| NPI | 1275160566 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Gerontology 363LG0600X |
| Practice location | 12 Pennington St Ste 100, Middletown, DE 19709 |
| Practice phone | 302-203-7113 |
| Mailing address | 111 Tuscany Dr, Middletown, DE 19709 |
| Enumerated | March 25, 2020 |
| Last updated | August 11, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Acute Care | 363LA2100X | AC005200 (MD) |
| Nurse Practitioner, Gerontology primary | 363LG0600X | LP-0000365 (DE) |
| Nurse Practitioner, Acute Care | 363LA2100X | 845356 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.