Provider Demographics
NPI:1366022485
Name:RUKAVINA, MADELINE E (MD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:E
Last Name:RUKAVINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 GRAY HAWK RD APT C
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2797
Mailing Address - Country:US
Mailing Address - Phone:859-327-9765
Mailing Address - Fax:
Practice Address - Street 1:719 THOMPSON LN STE 20400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4600
Practice Address - Country:US
Practice Address - Phone:218-761-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program