Individual
MADISON FADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
8505 COLLEGE BLVD, OVERLAND PARK, KS 66210-1836
(913) 541-3230
Mailing address
8505 COLLEGE BLVD, OVERLAND PARK, KS 66210-1836
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-145718-121
KS
207N00000X
Dermatology Physician
53-83293-121
KS
363LF0000X
Family Nurse Practitioner
Primary
53-83293-121
KS
Other
Enumeration date
08/22/2023
Last updated
10/23/2024
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