Basic Information
| Provider Information | |||||||||
| NPI: | 1043476104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KANE | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 VERNON LN | ||||||||
| Address2: | |||||||||
| City: | GARNET VALLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190611320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105580936 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2106 SILVERSIDE RD | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198104162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024779660 | ||||||||
| FaxNumber: | 3024779495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2008 | ||||||||
| LastUpdateDate: | 02/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | LH0000135 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 363LX0001X | SP001405G | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 363L00000X | RN264222L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.