Provider Demographics
NPI:1306253281
Name:DIDONATO, EDDA E (FAMILY NP)
Entity type:Individual
Prefix:
First Name:EDDA
Middle Name:E
Last Name:DIDONATO
Suffix:
Gender:F
Credentials:FAMILY NP
Other - Prefix:
Other - First Name:EDDA
Other - Middle Name:E
Other - Last Name:VARGAS DIDONATO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FAMILY NP
Mailing Address - Street 1:10 W LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-1424
Mailing Address - Country:US
Mailing Address - Phone:302-855-0915
Mailing Address - Fax:302-855-0914
Practice Address - Street 1:10 W LAUREL ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1424
Practice Address - Country:US
Practice Address - Phone:302-855-0915
Practice Address - Fax:302-855-0914
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-12
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000765363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty