Provider Demographics
NPI:1639977994
Name:PRICE, MADDISON L
Entity type:Individual
Prefix:
First Name:MADDISON
Middle Name:L
Last Name:PRICE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:68871-0163
Mailing Address - Country:US
Mailing Address - Phone:308-383-7889
Mailing Address - Fax:
Practice Address - Street 1:238 EAST 1ST STREET
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:NE
Practice Address - Zip Code:68871-6887
Practice Address - Country:US
Practice Address - Phone:308-383-7889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider