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General NPI Number Information
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NPI Number | 1912265380
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Entity Type | Individual
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Provider Name | MAURA ELLEN HINCKLE
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Gender | Female
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 1 CENTURIAN DR
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City | NEWARK
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State | DE
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Zip | 19713-2137
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Country | US
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Telephone | 302-999-0933
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Fax |
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Provider Business Mailing Address
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Address Line | 50 S EDGEWOOD LN
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City | ELKTON
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State | MD
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Zip | 21921-2178
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Country | US
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Telephone | 302-383-1389
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | LG0000603
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License Number State | DE
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