Provider Demographics
NPI:1275390643
Name:ADAMS, MADISON KATE (APN)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:KATE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 JOHNNY BOY LN
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2709
Mailing Address - Country:US
Mailing Address - Phone:856-701-6135
Mailing Address - Fax:
Practice Address - Street 1:2312 NEW RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1459
Practice Address - Country:US
Practice Address - Phone:800-978-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14936700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily