Provider Demographics
NPI:1215308531
Name:HONEYWELL, MANDY N (AUD)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:N
Last Name:HONEYWELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:N
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:752 N HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2236
Mailing Address - Country:US
Mailing Address - Phone:608-824-4000
Mailing Address - Fax:608-824-4868
Practice Address - Street 1:752 N HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2236
Practice Address - Country:US
Practice Address - Phone:608-824-4000
Practice Address - Fax:608-824-4868
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI657-156231H00000X
NC11687231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1215308531Medicaid
2232001OtherCIGNA
SCP01801628OtherRAILROAD MEDICARE
SCSA1610Medicaid
SCP01801628OtherRAILROAD MEDICARE
SCQ519065874Medicare PIN