Provider Demographics
NPI:1073141602
Name:SCIPIONE, MADELINE OLIVIA
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:OLIVIA
Last Name:SCIPIONE
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 1:10281 BRICKERTON DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-5847
Mailing Address - Country:US
Mailing Address - Phone:540-533-9393
Mailing Address - Fax:
Practice Address - Street 1:11601 ROBIOUS RD STE 100
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-5605
Practice Address - Country:US
Practice Address - Phone:804-379-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001266527163W00000X
VA0024182948363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse