Provider Demographics
NPI:1508363326
Name:OLKES, MADISON EMILY (FNP-C)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:EMILY
Last Name:OLKES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-2301
Mailing Address - Country:US
Mailing Address - Phone:305-972-3702
Mailing Address - Fax:
Practice Address - Street 1:1440 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:305-972-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9434696363LF0000X
NYF344792-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily