Individual
CHASTIDY MADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
308 W PIKE AVE, PETERSBURG, IN 47567-8755
(812) 354-8834
Mailing address
3100 S WALNUT STREET PIKE APT B158, BLOOMINGTON, IN 47401-7369
(812) 322-4979
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28169520A
IN
363LF0000X
Family Nurse Practitioner
Primary
71015638A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861367161
NPI
IN
Enumeration date
07/16/2024
Last updated
10/07/2025
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