Individual
BETTY MARIE MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41235 CHESTNUT ST, PALMDALE, CA 93551-2864
(661) 886-6312
Mailing address
41235 CHESTNUT ST, PALMDALE, CA 93551-2864
(661) 886-6312
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95106908
CA
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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