Provider Demographics
NPI:1235977075
Name:FAUST, MALLORY ANN SYKES (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:ANN SYKES
Last Name:FAUST
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 14TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1013
Mailing Address - Country:US
Mailing Address - Phone:302-320-2962
Mailing Address - Fax:302-320-4934
Practice Address - Street 1:501 W 14TH ST FL 3
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-320-2962
Practice Address - Fax:302-320-4934
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010686363LP0808X, 363LP0808X
DEL1-0070369163W00000X
MDAC006879363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse