Individual
MADISON WINDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2392 W JADE WAY, WEST HAVEN, UT 84401-8612
(208) 339-2094
Mailing address
2392 W JADE WAY, WEST HAVEN, UT 84401-8612
(208) 339-2094
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
13714215-3101
UT
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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