Healthcare Provider Details

I. General information

NPI: 1467030700
Provider Name (Legal Business Name): MADISON CLAIRE DRESSLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PROVIDENCE WAY STE 200
NICHOLASVILLE KY
40356-6033
US

IV. Provider business mailing address

100 PROVIDENCE WAY STE 200
NICHOLASVILLE KY
40356-6033
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-5370
  • Fax: 859-260-5379
Mailing address:
  • Phone: 859-260-5370
  • Fax: 859-260-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTP413
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTP413
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: