Provider Demographics
NPI:1184057788
Name:CORTEZ, MADELINE KAYE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:KAYE
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2912
Mailing Address - Country:US
Mailing Address - Phone:580-256-3174
Mailing Address - Fax:580-256-3502
Practice Address - Street 1:1818 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2912
Practice Address - Country:US
Practice Address - Phone:580-256-3174
Practice Address - Fax:580-256-3502
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily