Provider Demographics
NPI:1265638449
Name:MADDEN, SANDRA J (RNC, CDE)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:MADDEN
Suffix:
Gender:F
Credentials:RNC, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ADAMS GRN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6330
Mailing Address - Country:US
Mailing Address - Phone:603-472-4049
Mailing Address - Fax:
Practice Address - Street 1:DARTMOUTH HITCHCOCK
Practice Address - Street 2:100 HITCHCOCK WAY
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-629-1795
Practice Address - Fax:603-695-2721
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH038738-21163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator