Provider Demographics
NPI:1659551059
Name:MADSEN, JOAN MARIE (RNC CNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:MADSEN
Suffix:
Gender:F
Credentials:RNC CNP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:STEGMAIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17 W EXCHANGE ST
Mailing Address - Street 2:#622 METROPOLITAN OBSTETRICS & GYNECOLOGY PA
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-227-9141
Mailing Address - Fax:651-265-6772
Practice Address - Street 1:17 W EXCHANGE ST
Practice Address - Street 2:#622
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-227-9141
Practice Address - Fax:651-265-6772
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0812298163W00000X
MNMA0104299101363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse