Provider Demographics
NPI:1134335854
Name:MADDEN, LORI ANN STROBUSH (RN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN STROBUSH
Last Name:MADDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:STROBUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 SMITH AVE N
Mailing Address - Street 2:#500
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-292-0616
Mailing Address - Fax:651-379-4484
Practice Address - Street 1:225 SMITH AVE N
Practice Address - Street 2:#500
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-292-0616
Practice Address - Fax:651-379-4484
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1040810163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse