Provider Demographics
NPI:1114765369
Name:ONSOMU, STELLAH BOSIBORI
Entity type:Individual
Prefix:
First Name:STELLAH
Middle Name:BOSIBORI
Last Name:ONSOMU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9397
Mailing Address - Country:US
Mailing Address - Phone:302-559-8573
Mailing Address - Fax:302-559-8573
Practice Address - Street 1:108 PEACHTREE LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9397
Practice Address - Country:US
Practice Address - Phone:302-559-8573
Practice Address - Fax:302-559-8573
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010666363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health