Healthcare Provider Details

I. General information

NPI: 1437067444
Provider Name (Legal Business Name): MADISON MARIE FISHER I LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 E SPRUCE ST
GARDEN CITY KS
67846-6296
US

IV. Provider business mailing address

1505 E SPRUCE ST
GARDEN CITY KS
67846-6296
US

V. Phone/Fax

Practice location:
  • Phone: 620-275-9651
  • Fax: 620-275-0809
Mailing address:
  • Phone: 620-275-9651
  • Fax: 620-275-0809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberLBSW
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLBSW
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLBSW
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLBSW
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: