Provider Demographics
NPI:1699554667
Name:LAMB, MADISON RYAN (RN BSN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:RYAN
Last Name:LAMB
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 CADE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-7554
Mailing Address - Country:US
Mailing Address - Phone:843-373-9433
Mailing Address - Fax:
Practice Address - Street 1:3920 CADE RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-7554
Practice Address - Country:US
Practice Address - Phone:843-373-9433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC270752363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool