Provider Demographics
NPI:1043476104
Name:KANE, MAUREEN J (MSN)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:J
Last Name:KANE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 VERNON LN
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19061-1320
Mailing Address - Country:US
Mailing Address - Phone:610-558-0936
Mailing Address - Fax:
Practice Address - Street 1:2106 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4162
Practice Address - Country:US
Practice Address - Phone:302-477-9660
Practice Address - Fax:302-477-9495
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH0000135363LX0001X
PASP001405G363LX0001X
PARN264222L363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology