Healthcare Provider Details

I. General information

NPI: 1972411452
Provider Name (Legal Business Name): MADIELYNN MUELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4238 N PARKWAY AVE
SCOTTSDALE AZ
85251-4002
US

IV. Provider business mailing address

4238 N PARKWAY AVE
SCOTTSDALE AZ
85251-4002
US

V. Phone/Fax

Practice location:
  • Phone: 712-363-7878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number179785
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: