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General NPI Number Information
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NPI Number | 1568128890
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Entity Type | Individual
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Provider Name | MLEANEN MARCIA GILMAN NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 677 E PULASKI HWY
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City | ELKTON
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State | MD
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Zip | 21921-6037
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Country | US
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Telephone | 302-595-3670
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Fax |
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Provider Business Mailing Address
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Address Line | 141 EDGAR RD
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City | TOWNSEND
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State | DE
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Zip | 19734-2417
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Country | US
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Telephone | 302-464-9757
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SPO24714
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC004580
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0011814
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License Number State | DE
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