Healthcare Provider Details

I. General information

NPI: 1336721513
Provider Name (Legal Business Name): MADISON CEBULA MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADISON LEIGH CEBULA NP

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OGLETOWN-STANTON ROAD SUITE 1500
NEWARK DE
19713
US

IV. Provider business mailing address

4701 OGLETOWN-STANTON ROAD SUITE 1500
NEWARK DE
19713
US

V. Phone/Fax

Practice location:
  • Phone: 443-907-0983
  • Fax: 302-327-7635
Mailing address:
  • Phone: 443-907-0983
  • Fax: 302-327-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011589
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0051082
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: