Provider Demographics
NPI:1245078104
Name:WHALEY, MADISON (RN)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:
Last Name:WHALEY
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 1:2712 ASPEN PINES DR
Mailing Address - Street 2:
Mailing Address - City:WILDER
Mailing Address - State:KY
Mailing Address - Zip Code:41071-0451
Mailing Address - Country:US
Mailing Address - Phone:859-415-6757
Mailing Address - Fax:
Practice Address - Street 1:2712 ASPEN PINES DR
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:KY
Practice Address - Zip Code:41071-0451
Practice Address - Country:US
Practice Address - Phone:859-415-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20213540163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health