Provider Demographics
NPI:1386602506
Name:MADISON, KAREN L (CPN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:MADISON
Suffix:
Gender:F
Credentials:CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 EVELYN BYRD AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3487
Mailing Address - Country:US
Mailing Address - Phone:540-434-0559
Mailing Address - Fax:540-434-2478
Practice Address - Street 1:1871 EVELYN BYRD AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3487
Practice Address - Country:US
Practice Address - Phone:540-434-0559
Practice Address - Fax:540-434-2478
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024064089363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPENDINGMedicaid
VAPENDINGMedicare UPIN
VAPENDINGMedicaid