Provider Demographics
NPI:1851197834
Name:MADONIA, KATRINA LEE (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:LEE
Last Name:MADONIA
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:KATRINA
Other - Middle Name:LEE
Other - Last Name:BLANNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-2102
Mailing Address - Country:US
Mailing Address - Phone:570-362-0477
Mailing Address - Fax:
Practice Address - Street 1:335 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-3808
Practice Address - Country:US
Practice Address - Phone:570-825-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP032225363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health