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Individual
WENDY DENISE MADISON
Active
Individual
WENDY DENISE MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
84648
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200614820 A
—
OK
01
—
449026YRHZ
MEDICARE PTAN
OK
Enumeration date
10/15/2015
Last updated
12/28/2017
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