Provider Demographics
NPI:1508579111
Name:CENKUS, MADISON PAIGE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:PAIGE
Last Name:CENKUS
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 1:19669 BLUE JAY TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:LAWSON
Mailing Address - State:MO
Mailing Address - Zip Code:64062-7032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19669 BLUE JAY TRAIL CIR
Practice Address - Street 2:
Practice Address - City:LAWSON
Practice Address - State:MO
Practice Address - Zip Code:64062-7032
Practice Address - Country:US
Practice Address - Phone:816-739-0762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018003561163WC0200X
MO2023004708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine