Individual
JEFFREY K MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2 PALATINE, ALISO VIEJO, CA 92656-4295
(478) 318-5722
Mailing address
2 PALATINE, ALISO VIEJO, CA 92656-4295
(478) 318-5726
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95000337
CA
367500000X
Certified Registered Nurse Anesthetist
RN159372
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288788035B
PEACHSTATE CMO - MCCG
GA
05
—
288788035B
—
GA
01
—
344353
WELLCARE CMO - MCCG
GA
01
—
P00319935
RAILROAD MCR - MCCG
GA
Enumeration date
05/01/2007
Last updated
01/13/2020
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