Healthcare Provider Details

I. General information

NPI: 1699687376
Provider Name (Legal Business Name): MADALYN WOODBURN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 E 6TH ST
YORK NE
68467-3122
US

IV. Provider business mailing address

648 E 6TH ST
YORK NE
68467-3122
US

V. Phone/Fax

Practice location:
  • Phone: 402-363-9584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: