Provider Demographics
NPI:1376365957
Name:KINCAID, MADISON E (RN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:E
Last Name:KINCAID
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 1:4830 JET WING CIR W
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-2149
Mailing Address - Country:US
Mailing Address - Phone:360-298-1474
Mailing Address - Fax:
Practice Address - Street 1:4830 JET WING CIR W
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-2149
Practice Address - Country:US
Practice Address - Phone:360-298-1474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1699842163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse