Individual
DONNA LYNN MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 577-4200
(317) 577-9503
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001149387
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0001149387
IN
367500000X
Certified Registered Nurse Anesthetist
0024168152
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200104
MEDICARE PTAN
IN
01
—
264430F99
MEDICARE PTAN
IN
05
—
300068094
—
IN
Enumeration date
07/18/2006
Last updated
11/21/2023
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