Healthcare Provider Details

I. General information

NPI: 1801652706
Provider Name (Legal Business Name): MADELINE NEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E 2ND ST
DULUTH MN
55805-1913
US

IV. Provider business mailing address

502 E 2ND ST
DULUTH MN
55805-1913
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-3421
  • Fax:
Mailing address:
  • Phone: 218-786-3421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: