Healthcare Provider Details

I. General information

NPI: 1215722814
Provider Name (Legal Business Name): MADISON NICOLE MCBRIDE MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON NICOLE INGMAN

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 S 1ST AVE STE 100
MARSHALLTOWN IA
50158-5032
US

IV. Provider business mailing address

6800 LAKE DR STE 285
WEST DES MOINES IA
50266-2544
US

V. Phone/Fax

Practice location:
  • Phone: 515-226-3116
  • Fax: 515-223-9341
Mailing address:
  • Phone: 641-753-2150
  • Fax: 515-223-9341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA189766
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA189766
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: