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Individual
MRS. PATRICIA C MADER
Active
Individual
MRS. PATRICIA C MADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4150P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000360626
ANTHEM
KY
01
—
000000486305
ANTHEM PIN
KY
01
—
2646419000
PASSPORT ADVANTAGE
KY
01
—
50008080
PASSPORT
KY
05
—
78011855
—
KY
Enumeration date
06/17/2005
Last updated
12/19/2007
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