Healthcare Provider Details

I. General information

NPI: 1699082198
Provider Name (Legal Business Name): MARYANN V. DAFFEH APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MIDDLEFORD RD
SEAFORD DE
19973-3636
US

IV. Provider business mailing address

801 MIDDLEFORD RD
SEAFORD DE
19973-3636
US

V. Phone/Fax

Practice location:
  • Phone: 302-536-5260
  • Fax: 302-628-6355
Mailing address:
  • Phone: 302-536-5260
  • Fax: 302-628-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.11739
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.11739
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: