Healthcare Provider Details

I. General information

NPI: 1801548532
Provider Name (Legal Business Name): MADELINE AMEND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ALTAIR PKWY STE 3100
WESTERVILLE OH
43082-7653
US

IV. Provider business mailing address

400 ALTAIR PKWY STE 3100
WESTERVILLE OH
43082-7653
US

V. Phone/Fax

Practice location:
  • Phone: 614-360-9995
  • Fax: 844-571-1777
Mailing address:
  • Phone: 614-360-9995
  • Fax: 844-571-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number500327443
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33033
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number257255
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number227446
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24195188
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC008907
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025034848
License Number StateMO
# 8
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0039513
License Number StateOH
# 9
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1217828
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: