Individual
NICHOLAS C MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1201 S 7TH AVE, PHOENIX, AZ 85007-3917
(602) 344-6655
(602) 344-6658
Mailing address
2808 EAST GARY WAY, PHOENIX, AZ 85042
(602) 296-5012
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
088121
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168395
—
OR
01
—
R103163
MEDICARE PART B
OR
Enumeration date
09/07/2007
Last updated
01/22/2015
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