Provider Demographics
NPI:1487441069
Name:RANDOLPH, MADELEINE KATHRYN (MD)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:KATHRYN
Last Name:RANDOLPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:KATHYRN
Other - Last Name:LAFOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 NORTHWAY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4913
Mailing Address - Country:US
Mailing Address - Phone:320-240-3157
Mailing Address - Fax:320-240-3165
Practice Address - Street 1:1555 NORTHWAY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4555
Practice Address - Country:US
Practice Address - Phone:320-240-3157
Practice Address - Fax:320-240-3165
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program