| NPI | 1619707593 |
|---|---|
| Former Name | CAROLYN ANN MADSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: ID 7161372) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |