Provider Demographics
NPI:1053073338
Name:HAND, MADISON B
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:B
Last Name:HAND
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 1:2314 6TH AVE SE STE D
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6565
Mailing Address - Country:US
Mailing Address - Phone:256-686-3159
Mailing Address - Fax:
Practice Address - Street 1:2314 6TH AVE SE STE D
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6565
Practice Address - Country:US
Practice Address - Phone:256-686-3159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-21-188675374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALRBT-21-188675OtherRBT