Provider Demographics
NPI:1902244411
Name:MALDONADO, MONICA (NP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 NEW CASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5821
Mailing Address - Country:US
Mailing Address - Phone:302-655-6187
Mailing Address - Fax:
Practice Address - Street 1:601 NEW CASTLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5821
Practice Address - Country:US
Practice Address - Phone:302-655-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR231216363LW0102X
DELH-0000237363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK5820009OtherCAREFIRST
NJ0387622Medicaid