Provider Demographics
NPI:1215292115
Name:KANGE, MADELEINE (LPN)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:KANGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5607 LITTLE BEN CIR
Mailing Address - Street 2:APT C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-3024
Mailing Address - Country:US
Mailing Address - Phone:469-554-1116
Mailing Address - Fax:
Practice Address - Street 1:5607 LITTLE BEN CIR
Practice Address - Street 2:APT C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-3024
Practice Address - Country:US
Practice Address - Phone:469-554-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH149202164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse