Provider Demographics
NPI:1225713951
Name:BEARDMORE, MADISON LYNN
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:LYNN
Last Name:BEARDMORE
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 1:2740 US ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:HOOKSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15050
Mailing Address - Country:US
Mailing Address - Phone:412-779-8646
Mailing Address - Fax:
Practice Address - Street 1:1136 THORN RUN RD
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-4301
Practice Address - Country:US
Practice Address - Phone:412-262-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant