Individual
CHAD M MADERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
827 N PINE ST, GRAMERCY, LA 70052-3659
(225) 869-9200
(225) 869-9241
Mailing address
827 N PINE ST, GRAMERCY, LA 70052-3659
(225) 869-9200
(225) 869-9241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TAP003099
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2349686
—
LA
Enumeration date
06/14/2013
Last updated
01/24/2014
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