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Individual

JEFFREY K MADDEN

Active
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Individual

JEFFREY K MADDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

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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