Provider Demographics
NPI:1558076281
Name:SMITHEY, MADISON MARIE (RN)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:MARIE
Last Name:SMITHEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 BLACKTHORN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-5543
Mailing Address - Country:US
Mailing Address - Phone:317-504-7869
Mailing Address - Fax:
Practice Address - Street 1:2423 N NATIONAL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3733
Practice Address - Country:US
Practice Address - Phone:812-372-7804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28222150A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse