Healthcare Provider Details

I. General information

NPI: 1487408407
Provider Name (Legal Business Name): MADELINE FICKES APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 10TH AVE FL 1
COLUMBUS OH
43210-1280
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-5066
  • Fax: 614-293-9449
Mailing address:
  • Phone: 614-293-5066
  • Fax: 614-293-9449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0036606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: