Provider Demographics
NPI:1154299519
Name:WARRICK, MADISON TAYLOR (PA)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:TAYLOR
Last Name:WARRICK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 JESSE HARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6832
Mailing Address - Country:US
Mailing Address - Phone:702-274-0658
Mailing Address - Fax:
Practice Address - Street 1:1093 JESSE HARBOR AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6832
Practice Address - Country:US
Practice Address - Phone:702-274-0658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant