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General NPI Number Information
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NPI Number | 1649586793
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Entity Type | Individual
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Provider Name | MARYANN EASTEP MS,RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 206 ODESSA WAY
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City | NEWARK
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State | DE
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Zip | 19711-4130
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Country | US
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Telephone | 302-737-6413
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Fax | 302-737-6413
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Provider Business Mailing Address
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Address Line | 206 ODESSA WAY
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City | NEWARK
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State | DE
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Zip | 19711-4130
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Country | US
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Telephone | 302-737-6413
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Fax | 302-737-6413
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | DN-0000400
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN-000040
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | DN-0000400
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License Number State | DE
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