Healthcare Provider Details

I. General information

NPI: 1184250953
Provider Name (Legal Business Name): MAUREEN A SECKEL CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-6023
  • Fax:
Mailing address:
  • Phone: 302-733-6023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number0000116
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0018735
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: