Provider Demographics
NPI:1568030559
Name:KALTENBERGER, MADISON TAYLOR (MGC, CGC)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:TAYLOR
Last Name:KALTENBERGER
Suffix:
Gender:F
Credentials:MGC, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-4802
Mailing Address - Country:US
Mailing Address - Phone:402-481-6328
Mailing Address - Fax:
Practice Address - Street 1:7501 S 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-4802
Practice Address - Country:US
Practice Address - Phone:402-481-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS