Provider Demographics
NPI:1033179346
Name:MADSEN, AARON JEFFREY (MBA, ATC, LAT, NREMT)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:JEFFREY
Last Name:MADSEN
Suffix:
Gender:M
Credentials:MBA, ATC, LAT, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 W 47TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-1257
Mailing Address - Country:US
Mailing Address - Phone:402-641-2509
Mailing Address - Fax:308-236-7027
Practice Address - Street 1:2605 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4416
Practice Address - Country:US
Practice Address - Phone:308-236-7016
Practice Address - Fax:308-236-7027
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13052146N00000X
NE3122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic