Provider Demographics
NPI:1407333826
Name:HAO, MADELEINE WILSON (DNP, FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:WILSON
Last Name:HAO
Suffix:
Gender:F
Credentials:DNP, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:MARY
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:11260 ROGER BACON DR STE 204
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5252
Mailing Address - Country:US
Mailing Address - Phone:703-420-3267
Mailing Address - Fax:703-420-3654
Practice Address - Street 1:11260 ROGER BACON DR STE 204
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5252
Practice Address - Country:US
Practice Address - Phone:703-420-3267
Practice Address - Fax:703-420-3654
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001260582163W00000X
DC1049832363L00000X, 363LF0000X, 363LP0808X
VA0024176405363L00000X, 363LF0000X
MDACOO6501363LP0808X
MDAC002581363LF0000X
VA00245176405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily