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Individual
MADELINE PARK
Active
Individual
MADELINE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11905610-4405
UT
Other
Enumeration date
09/04/2013
Last updated
01/30/2026
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