Provider Demographics
NPI:1588424907
Name:CHASE, MADELINE P
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:P
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:MANDAREE
Mailing Address - State:ND
Mailing Address - Zip Code:58757-0548
Mailing Address - Country:US
Mailing Address - Phone:701-421-0905
Mailing Address - Fax:
Practice Address - Street 1:1355 HIGHWAY 22 NORTH
Practice Address - Street 2:
Practice Address - City:MANDAREE
Practice Address - State:ND
Practice Address - Zip Code:58757
Practice Address - Country:US
Practice Address - Phone:701-421-0905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider