Healthcare Provider Details

I. General information

NPI: 1245175603
Provider Name (Legal Business Name): JUSTINE ECKMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 FORGE RD
NEWARK DE
19711-7619
US

IV. Provider business mailing address

14 FORGE RD
NEWARK DE
19711-7619
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2180
  • Fax:
Mailing address:
  • Phone: 302-454-2180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN771572
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: