Individual
MICHELLE SHELLEY MADSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD,CDE
Contact information
Practice address
6500 N MOPAC, BLDG III, STE 220, AUSTIN, TX 78731
(512) 338-4500
(512) 338-4501
Mailing address
PO BOX 500202, AUSTIN, TX 78750-0202
(512) 250-9140
(512) 250-2207
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT03472
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077HC
BCBS
TX
Enumeration date
06/08/2006
Last updated
07/02/2014
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