Provider Demographics
NPI:1336721513
Name:CEBULA, MADISON LEIGH (FNP)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:LEIGH
Last Name:CEBULA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 CHRISTIANA RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3118
Mailing Address - Country:US
Mailing Address - Phone:302-327-7630
Mailing Address - Fax:302-327-7635
Practice Address - Street 1:94 CHRISTIANA RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3118
Practice Address - Country:US
Practice Address - Phone:302-327-7630
Practice Address - Fax:302-327-7635
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0051082163W00000X
DELG-0011589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse