Healthcare Provider Details

I. General information

NPI: 1194945725
Provider Name (Legal Business Name): MAUREEN L EGAN ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAUREEN LUCEY

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND ROAD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

PO BOX 191
ROCKLAND DE
19723-0191
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4000
  • Fax: 302-651-5838
Mailing address:
  • Phone: 302-651-6212
  • Fax: 302-651-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP002236N
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLJ0000242
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: