Healthcare Provider Details

I. General information

NPI: 1033837075
Provider Name (Legal Business Name): MADELYN JEAN WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADELYN FRANA

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 08/09/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MAIN ST N
PIERZ MN
56364-4539
US

IV. Provider business mailing address

1101 1ST AVE N APT 205
SAUK RAPIDS MN
56379-2108
US

V. Phone/Fax

Practice location:
  • Phone: 320-204-0489
  • Fax: 612-500-4491
Mailing address:
  • Phone: 952-270-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33976
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: