Provider Demographics
NPI:1043954506
Name:KESSLER, MADISON NICOLE
Entity Type:Individual
Prefix:MS
First Name:MADISON
Middle Name:NICOLE
Last Name:KESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 SHERIDEN DR STE C
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:OH
Mailing Address - Zip Code:43316-1502
Mailing Address - Country:US
Mailing Address - Phone:419-396-7977
Mailing Address - Fax:419-396-6292
Practice Address - Street 1:930 SHERIDEN DR STE C
Practice Address - Street 2:
Practice Address - City:CAREY
Practice Address - State:OH
Practice Address - Zip Code:43316-1502
Practice Address - Country:US
Practice Address - Phone:419-396-7977
Practice Address - Fax:419-396-6292
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09316254183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician