Healthcare Provider Details

I. General information

NPI: 1619892643
Provider Name (Legal Business Name): MADISON YEZEK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3893 WILLIAM PENN HWY
MONROEVILLE PA
15146-2127
US

IV. Provider business mailing address

3893 WILLIAM PENN HWY
MONROEVILLE PA
15146-2127
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP036787
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: