Healthcare Provider Details

I. General information

NPI: 1912139213
Provider Name (Legal Business Name): MARIANNE MILLIS MCEVOY ABRAMS MSN,CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 S GOVERNORS AVE
DOVER DE
19904-4158
US

IV. Provider business mailing address

1110 WOODSEDGE RD
DOVER DE
19904-4366
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-5200
  • Fax: 302-678-5277
Mailing address:
  • Phone: 302-670-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLK-0000103
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: