Healthcare Provider Details

I. General information

NPI: 1598678831
Provider Name (Legal Business Name): AMY MADDEN BSN, RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 JAGUAR SPUR AVE
DELAWARE OH
43015-3422
US

IV. Provider business mailing address

276 JAGUAR SPUR AVE
DELAWARE OH
43015-3422
US

V. Phone/Fax

Practice location:
  • Phone: 740-816-2505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number295997
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: