Provider Demographics
NPI:1750183455
Name:CLINE, MADELYN RENEE
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:RENEE
Last Name:CLINE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:MADELYN
Other - Middle Name:RENEE
Other - Last Name:STRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3816 STOLEN HORSE TRCE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2782
Mailing Address - Country:US
Mailing Address - Phone:502-718-7562
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST # 217A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-218-0064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY1166176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program